Provider Demographics
NPI:1407967557
Name:KLAMATH HOSPICE, INC.
Entity Type:Organization
Organization Name:KLAMATH HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-882-2902
Mailing Address - Street 1:2751 WASHBURN WAY
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4958
Mailing Address - Country:US
Mailing Address - Phone:541-882-2902
Mailing Address - Fax:541-883-1992
Practice Address - Street 1:2751 WASHBURN WAY
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4958
Practice Address - Country:US
Practice Address - Phone:541-882-2902
Practice Address - Fax:541-883-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC00006FOtherMEDICAL ID NUMBER
OR132634Medicaid
OR132634Medicaid