Countryside Hospice Care INC
NPI #1265470249 in La Fayette, Georgia
Provider Information
- NPI Number
- 1265470249
- Entity Type
- Organization
- Organization Name
- Countryside Hospice Care INC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COUNTRYSIDE HOSPICE CARE INC
- Primary Specialty
- Hospice Care, Community Based
- Enumeration Date
- Jun 3, 2006
- Last Updated
- Feb 16, 2012
Practice Location
- Address
- 106 PEARL DR
- Address 2
- SUITE 107
- City
- La Fayette
- State
- Georgia
- ZIP Code
- 30728-7509
- Phone
- (706) 638-7651
Authorized Official
- Name
- MR. GLEN CAVALLO
- Title
- SR. VP - OPERATIONS
- Phone
- (479) 996-5900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Hospice Care, Community Based |
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