Provider Demographics
NPI:1861844771
Name:CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Entity Type:Organization
Organization Name:CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Other - Org Name:CENTER FOR ADULT DAY SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMMERCIAL BILLING REP
Authorized Official - Prefix:
Authorized Official - First Name:SARI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-367-2458
Mailing Address - Street 1:111 SUNNYBROOK CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-3437
Mailing Address - Country:US
Mailing Address - Phone:574-243-3100
Mailing Address - Fax:574-822-4876
Practice Address - Street 1:111 SUNNYBROOK CT
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-3437
Practice Address - Country:US
Practice Address - Phone:574-232-2666
Practice Address - Fax:574-742-4299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-05
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN151501OtherHOSPICE MEDICARE PROVIDER
IN151501OtherHOSPICE MEDICARE PROVIDER