Provider Demographics
NPI:1093717340
Name:MT HOOD HOSPICE
Entity Type:Organization
Organization Name:MT HOOD HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FRANKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-668-5545
Mailing Address - Street 1:PO BOX 1269
Mailing Address - Street 2:39641 SCENIC ST.
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-1269
Mailing Address - Country:US
Mailing Address - Phone:503-668-5545
Mailing Address - Fax:503-668-7951
Practice Address - Street 1:39085 PIONEER BLVD STE 1018
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8081
Practice Address - Country:US
Practice Address - Phone:503-668-5545
Practice Address - Fax:503-668-7951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1983-001251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR132196Medicaid
OR132196Medicaid