Provider Demographics
NPI:1841343472
Name:CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Entity type:Organization
Organization Name:CENTER FOR HOSPICE AND PALLIATIVE CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMMERCIAL BILLING REP
Authorized Official - Prefix:MS
Authorized Official - First Name:SARI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-367-2458
Mailing Address - Street 1:501 COMFORT PL
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-5234
Mailing Address - Country:US
Mailing Address - Phone:574-243-3100
Mailing Address - Fax:574-217-4874
Practice Address - Street 1:501 COMFORT PL
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-5234
Practice Address - Country:US
Practice Address - Phone:574-243-3100
Practice Address - Fax:574-217-4874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060052791251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100273050AMedicaid