Healthcare Provider Details

I. General information

NPI: 1366646671
Provider Name (Legal Business Name): MADRONE HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W CENTER ST
YREKA CA
96097-2907
US

IV. Provider business mailing address

255 COLLIER CIR
YREKA CA
96097-2276
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-3466
  • Fax: 530-842-3588
Mailing address:
  • Phone: 530-842-3160
  • Fax: 530-842-6412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AUDREY FLOWER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 530-842-3160