Provider Demographics
NPI:1477979805
Name:COLONIAL HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:COLONIAL HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-861-7671
Mailing Address - Street 1:224 E OLIVE AVE
Mailing Address - Street 2:SUIT 218
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1239
Mailing Address - Country:US
Mailing Address - Phone:818-861-7671
Mailing Address - Fax:818-861-7670
Practice Address - Street 1:224 E OLIVE AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1239
Practice Address - Country:US
Practice Address - Phone:818-861-7671
Practice Address - Fax:818-861-7670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based