Organization
COUNTRYSIDE HOSPICE CARE INC
Active
Parent organization
COUNTRYSIDE HOSPICE CARE INC
Other names
Countryside Hospice Roanoke
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTRYSIDE HOSPICE CARE INC
Authorized official
MR. GLEN CAVALLO (SR. VP - OPERATIONS)
(479) 996-5900
Entity
Organization
Contact information
Practice address
3355 HIGHWAY 431, SUITE 3, ROANOKE, AL 36274-2723
(334) 863-4984
(334) 863-4999
Mailing address
101 SUN AVE NE, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
06/04/2006
Last updated
01/26/2011
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