Provider Demographics
NPI:1396746095
Name:CARING HANDS HOSPICE
Entity type:Organization
Organization Name:CARING HANDS HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNERADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KROEGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-771-3964
Mailing Address - Street 1:3579 N 2175 E
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-2427
Mailing Address - Country:US
Mailing Address - Phone:801-771-3964
Mailing Address - Fax:801-771-3988
Practice Address - Street 1:3579 N 2175 E
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-2427
Practice Address - Country:US
Practice Address - Phone:801-771-3964
Practice Address - Fax:801-771-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2003-HOSPICE-33822251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========011Medicaid
UT461505Medicare ID - Type UnspecifiedCARING HANDS HOSPICE