Healthcare Provider Details

I. General information

NPI: 1093466690
Provider Name (Legal Business Name): BERKLEY PALLIATIVE CARE AND HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10697 E DARTMOUTH AVE
AURORA CO
80014-2616
US

IV. Provider business mailing address

10697 E DARTMOUTH AVE
AURORA CO
80014-2616
US

V. Phone/Fax

Practice location:
  • Phone: 303-758-2000
  • Fax: 303-758-2009
Mailing address:
  • Phone: 303-758-2000
  • Fax: 303-758-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE DONNAY
Title or Position: CFO
Credential: JD
Phone: 303-758-2000