| Organization Name: | SAFE HAVEN HOSPICE OF SOUTHERN ILLINOIS, LLC |
| NPI Number: | 1427419597 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY F PHILLIPPE (CEO) |
| Mailing Address: | 622 Emerson Rd Suite 310 Saint Louis |
| State: | MO US |
| Postal Code: | 631416727 |
| Phone Number: | 3145876727 |
| Fax Number: | |
| NPI Enumeration Date: | 03/16/2016 |
| NPI Last Update Date: | 03/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |