1861844771 NPI number — CENTER FOR HOSPICE AND PALLIATIVE CARE, INC

Table of content: (NPI 1861844771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861844771 NPI number — CENTER FOR HOSPICE AND PALLIATIVE CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861844771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 SUNNYBROOK CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH BEND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46637-3437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
574-243-3100
Provider Business Mailing Address Fax Number:
574-822-4876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 SUNNYBROOK CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BEND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46637-3437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-232-2666
Provider Business Practice Location Address Fax Number:
574-742-4299
Provider Enumeration Date:
07/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
SARI
Authorized Official Middle Name:
J
Authorized Official Title or Position:
COMMERCIAL BILLING REP
Authorized Official Telephone Number:
574-367-2458

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 151501 . This is a "HOSPICE MEDICARE PROVIDER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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