Provider Demographics
NPI:1629367750
Name:DEL CORAZON HOSPICE LLC
Entity type:Organization
Organization Name:DEL CORAZON HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, LNHA
Authorized Official - Phone:505-988-2049
Mailing Address - Street 1:811 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7641
Mailing Address - Country:US
Mailing Address - Phone:505-988-2049
Mailing Address - Fax:505-982-2930
Practice Address - Street 1:811 SAINT MICHAELS DR
Practice Address - Street 2:SUITE 207
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7641
Practice Address - Country:US
Practice Address - Phone:505-988-2049
Practice Address - Fax:505-982-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based