NPI 1013248814

Countryside Hospice Care, INC

Organisation Community Based Hospice Care Agency Canton, GA

Practice location

Address: 203 Oakside Ln Building 203, Suite B, Canton, GA 30114-6407
Phone: (770) 704-9982
Fax: (770) 704-2755
Mailing address: 203 Oakside Ln Building 203-B, Canton, GA 30114-6407

Authorised official

Name: Glen Cavallo
Title: Sr. Vp - Operations
Phone: (479) 996-5900

Registered specialties

Community Based Hospice Care Agency Primary

Agencies Taxonomy 251G00000X Licence 028-0350-H (GA)

Other Hospice Care, Community Based providers in Georgia →

Registry record

NPI: 1013248814
Entity type: Organization
NPI issued: 19 Jan 2010
Record last updated: 16 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.