NPIMap

Organization Active NPI

Residential Hospice of Southern Illinois, LLC

  • Community Based Hospice Care Agency
  • Saint Louis, MO
National Provider Identifier
1750009452
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC
Practice address
8706 Manchester Rd Ste 102
Saint Louis, MO 63144-2733
Phone
(314) 266-0950
NPI assigned
Aug 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Justin Dewitte
Title
President / Ceo
Phone
(866) 902-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

8706 Manchester Rd Ste 102
Saint Louis, MO 63144-2733

Mailing address

5440 Corporate Dr Ste 400
Troy, MI 48098-2645
Phone (866) 902-4000

Other names 1

  • Residential Hospice of E MO Doing business as

National Provider Directory

National Provider Directory

Locations

1809 W McCord St
Centralia, IL 62801
Phone (618) 532-7587

115 W 8th St
Mount Carmel, IL 62863
Phone (618) 262-7730

1702 Broadway St
Ste A
Mount Vernon, IL 62864
Phone (800) 358-8227

707 Walnut St
Ste 2
Murphysboro, IL 62966
Phone (877) 809-8388

702 Chestnut St
Murphysboro, IL 62966
Phone (618) 684-2670

1901 Frank Scott Pkwy E
Ste 2
Shiloh, IL 62269
Phone (800) 358-8227

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1750009452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CORPORATE DR STE 400",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982645",
            "telephone_number": "866-902-4000",
            "fax_number": "866-903-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 MANCHESTER RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442733",
            "telephone_number": "314-266-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "DEWITTE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "866-902-4000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residential Hospice of E MO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.