Organization Name: | MT HOOD HOSPICE |
NPI Number: | 1093717340 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEE ANN CHURCH (EXECUTIVE DIRECTOR) |
Mailing Address: | 39641 Scenic St Sandy |
State: | OR US |
Postal Code: | 970556405 |
Phone Number: | 5036685545 |
Fax Number: | 5036687951 |
NPI Enumeration Date: | 06/01/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 1983-001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |