Provider Demographics
NPI:1235581018
Name:CGC HOSPICE, INC
Entity Type:Organization
Organization Name:CGC HOSPICE, INC
Other - Org Name:AVANTE HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSES
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-558-7879
Mailing Address - Street 1:10935 ESTATE LN
Mailing Address - Street 2:SUITE S 400 A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2316
Mailing Address - Country:US
Mailing Address - Phone:469-730-4882
Mailing Address - Fax:214-853-4279
Practice Address - Street 1:10935 ESTATE LN
Practice Address - Street 2:SUITE S 400 A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:469-730-4882
Practice Address - Fax:214-853-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based