Provider Demographics
NPI:1881204055
Name:CENTRIC CARE HOSPICE, INC.
Entity Type:Organization
Organization Name:CENTRIC CARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETORY
Authorized Official - Prefix:
Authorized Official - First Name:KETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-728-0584
Mailing Address - Street 1:13405 FOLSOM BLVD STE 504
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4739
Mailing Address - Country:US
Mailing Address - Phone:916-603-3550
Mailing Address - Fax:916-603-3430
Practice Address - Street 1:9198 GREENBACK LN STE 114
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4770
Practice Address - Country:US
Practice Address - Phone:916-603-3550
Practice Address - Fax:916-603-3430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based