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Organization

COUNTRYSIDE HOSPICE CARE, INC

Active
Other names
SolAmor Hospice LaGrange
Organization subpart
No

Provider details

NPI number
Authorized official
GLEN CAVALLO (SR. VP - OPERATIONS)
(479) 996-5900
Entity
Organization

Contact information

Practice address
105 CORPORATE PLAZA DR, LAGRANGE, GA 30241-2801
(706) 845-8755
(706) 845-8757
Mailing address
101 SUN AVE NE, ALBUQUERQUE, NM 87109-4373
(505) 468-4681

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
038-156H
GA

Other

Enumeration date
01/25/2012
Last updated
02/16/2012
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