Safe Haven Hospice of Southern Illinois, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SAFE HAVEN HOSPICE OF SOUTHERN ILLINOIS, LLC

Practice address

622 Emerson Rd
Suite 310
Saint Louis, MO 63141-6727

Phone

(314) 587-6727

NPI assigned

Mar 16, 2016

Last updated

Mar 16, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy F Phillippe

Title

Ceo

Phone

(314) 587-7900

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1427419597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 EMERSON RD",
            "address_2": "SUITE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416727",
            "telephone_number": "314-587-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EMERSON RD",
            "address_2": "SUITE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416727",
            "telephone_number": "314-587-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN HOSPICE OF SOUTHERN ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "PHILLIPPE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-587-7900"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.