Provider Demographics
NPI:1619142791
Name:ECLIPSE HOSPICE CARE INC
Entity Type:Organization
Organization Name:ECLIPSE HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-712-4582
Mailing Address - Street 1:5242 COLLEGE DRIVE
Mailing Address - Street 2:#370
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2653
Mailing Address - Country:US
Mailing Address - Phone:801-293-1202
Mailing Address - Fax:801-293-1224
Practice Address - Street 1:5242 COLLEGE DRIVE
Practice Address - Street 2:#370
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2653
Practice Address - Country:US
Practice Address - Phone:801-293-1202
Practice Address - Fax:801-293-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based