| Organization Name: | HOSPICE OF KANKAKEE VALLEY PALLIATIVE CLINIC |
| NPI Number: | 1104906767 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOROTHEA M. LAGESSE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 482 Main Street Nw Bourbonnais |
| State: | IL US |
| Postal Code: | 609142331 |
| Phone Number: | 8159363370 |
| Fax Number: | 8159363375 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 315D00000X |
| License Number: | 2000420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Hospice, Inpatient |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |