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Organization

GOOD SHEPHERD HOSPICE OF MID-AMERICA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON KYLE DELESTER (PRESIDENT)
(405) 943-0903
Entity
Organization

Contact information

Practice address
123 W KANSAS AVE, INDEPENDENCE, MO 64050-3732
(816) 822-2292
(816) 822-2298
Mailing address
123 W KANSAS AVE, INDEPENDENCE, MO 64050-3732
(816) 822-2292
(816) 822-2298

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
1243H0
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
826099202
MO
Enumeration date
09/01/2006
Last updated
10/02/2024
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