Organization
COUNTRYSIDE HOSPICE CARE, INC
Active
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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