Provider Demographics
NPI:1396754255
Name:THE CONNECTICUT HOSPICE, INC
Entity type:Organization
Organization Name:THE CONNECTICUT HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GILHULY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-315-7633
Mailing Address - Street 1:100 DOUBLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4909
Mailing Address - Country:US
Mailing Address - Phone:203-315-7500
Mailing Address - Fax:203-315-7614
Practice Address - Street 1:100 DOUBLE BEACH RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4909
Practice Address - Country:US
Practice Address - Phone:203-315-7500
Practice Address - Fax:203-315-7614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC846210H251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004043709Medicaid
CT071500Medicare Oscar/Certification
CT077119Medicare Oscar/Certification