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Organization

KOSCIUSKO HOME CARE & HOSPICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD R PACZKOWSKI (ADMINISTRATOR)
(574) 372-3401
Entity
Organization

Contact information

Practice address
1515 PROVIDENT DR, SUITE 250, WARSAW, IN 46580-3294
(574) 372-3401
(574) 372-3415
Mailing address
1515 PROVIDENT DR, SUITE 250, WARSAW, IN 46580-3294
(574) 372-3401
(574) 372-3415

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
07-009511-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200297120
IN
Enumeration date
04/29/2008
Last updated
05/27/2009
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