Provider Demographics
NPI:1003486416
Name:CARING COVE HOSPICE LLC
Entity Type:Organization
Organization Name:CARING COVE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-302-2282
Mailing Address - Street 1:3120 N HOME ST
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-4438
Mailing Address - Country:US
Mailing Address - Phone:574-302-2282
Mailing Address - Fax:
Practice Address - Street 1:3120 N HOME ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-4438
Practice Address - Country:US
Practice Address - Phone:574-302-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based