Provider Demographics
NPI:1548738842
Name:GRACIA HOSPICE GROUP, INC.
Entity Type:Organization
Organization Name:GRACIA HOSPICE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-531-3172
Mailing Address - Street 1:7985 VANCE DR STE 308
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2120
Mailing Address - Country:US
Mailing Address - Phone:720-531-3172
Mailing Address - Fax:720-242-9110
Practice Address - Street 1:7985 VANCE DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2120
Practice Address - Country:US
Practice Address - Phone:720-531-3172
Practice Address - Fax:720-242-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based