Organization
BEACON OF HOPE HOSPICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN E. MULLINS R.N., B.S.N. (PRESIDENT/CEO)
(314) 815-3000
Entity
Organization
Contact information
Practice address
1020 WEST 35TH STREET, DAVENPORT, IA 52806-4440
(563) 391-6933
(563) 391-5104
Mailing address
2191 LEMAY FERRY RD, SUITE 300, SAINT LOUIS, MO 63125-2408
(314) 815-3500
(314) 815-3207
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2698587
IA
251G00000X
Community Based Hospice Care Agency
41537899
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0615526
MEDICAID
IA
Enumeration date
06/24/2005
Last updated
04/20/2008
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