Healthcare Provider Details

I. General information

NPI: 1427051325
Provider Name (Legal Business Name): CATHOLIC HOSPICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14875 NW 77TH AVE STE 100
MIAMI LAKES FL
33014-2568
US

IV. Provider business mailing address

14875 NW 77TH AVE STUITE 100
MIAMI LAKES FL
33014-2568
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-2380
  • Fax: 305-819-2281
Mailing address:
  • Phone: 305-822-2380
  • Fax: 305-819-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number5004095
License Number StateFL

VIII. Authorized Official

Name: MRS. MARY JO FRICK
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 954-648-8156