Provider Demographics
NPI:1639743685
Name:CAROLINA HOSPICE INC
Entity Type:Organization
Organization Name:CAROLINA HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAPANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-545-6669
Mailing Address - Street 1:10121 SE SUNNYSIDE RD STE 40
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5745
Mailing Address - Country:US
Mailing Address - Phone:707-454-6669
Mailing Address - Fax:
Practice Address - Street 1:10121 SE SUNNYSIDE RD STE 40
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5745
Practice Address - Country:US
Practice Address - Phone:707-454-6669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based