Provider Demographics
NPI:1700944717
Name:HOSPICE & PALLIATIVE CARE OF NORTHERN COLORADO
Entity Type:Organization
Organization Name:HOSPICE & PALLIATIVE CARE OF NORTHERN COLORADO
Other - Org Name:TRU HOSPICE OF NORTHERN COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-604-5244
Mailing Address - Street 1:2726 W. 11TH ST ROAD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:970-352-8487
Mailing Address - Fax:970-475-0038
Practice Address - Street 1:2726 W. 11TH ST ROAD
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634
Practice Address - Country:US
Practice Address - Phone:970-352-8487
Practice Address - Fax:970-475-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0633251G00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05800065Medicaid
CO05800065Medicaid