Provider Demographics
NPI:1750442513
Name:HIGH PEAKS HOSPICE AND PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:HIGH PEAKS HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-891-0606
Mailing Address - Street 1:1247 DIX AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-9618
Mailing Address - Country:US
Mailing Address - Phone:518-891-0606
Mailing Address - Fax:866-200-5117
Practice Address - Street 1:1247 DIX AVE
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-9618
Practice Address - Country:US
Practice Address - Phone:518-891-0606
Practice Address - Fax:866-200-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01098517Medicaid
NY01098517Medicaid