Provider Demographics
NPI:1093466690
Name:BERKLEY PALLIATIVE CARE AND HOSPICE, LLC
Entity Type:Organization
Organization Name:BERKLEY PALLIATIVE CARE AND HOSPICE, LLC
Other - Org Name:BERKLEY PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNAY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:303-758-2000
Mailing Address - Street 1:10697 E DARTMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2616
Mailing Address - Country:US
Mailing Address - Phone:303-758-2000
Mailing Address - Fax:303-758-2009
Practice Address - Street 1:10697 E DARTMOUTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2616
Practice Address - Country:US
Practice Address - Phone:303-758-2000
Practice Address - Fax:303-758-2009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKLEY PALLIATIVE CARE AND HOSPICE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000155355Medicaid