Organization
OPTUM PALLIATIVE AND HOSPICE CARE, INC.
Active
Parent organization
COLLABORATIVE CARE HOLDINGS, LLC
Other names
Evercare Hospice, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLABORATIVE CARE HOLDINGS, LLC
Authorized official
JOHN O ENDERLE (PRESIDENT/CEO)
(860) 221-0793
Entity
Organization
Contact information
Practice address
12018 SUNRISE VALLEY DRIVE, SUITE 401, RESTON, VA 20191-3434
(571) 262-5200
(571) 521-7249
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(215) 902-8241
(215) 902-8809
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
HSP-0625
VA
251G00000X
Community Based Hospice Care Agency
Primary
HSP12137
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4910427
—
VA
Enumeration date
05/17/2006
Last updated
11/04/2015
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