Organization
COUNTRYSIDE HOSPICE CARE, INC
Active
Other names
SolAmor Hospice Canton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN CAVALLO (SR. VP - OPERATIONS)
(479) 996-5900
Entity
Organization
Contact information
Practice address
203 OAKSIDE LN, BUILDING 203, SUITE B, CANTON, GA 30114-6407
(770) 704-9982
(770) 704-2755
Mailing address
203 OAKSIDE LN, BUILDING 203-B, CANTON, GA 30114-6407
(770) 704-9982
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
028-0350-H
GA
Other
Enumeration date
01/19/2010
Last updated
02/16/2012
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