Healthcare Provider Details

I. General information

NPI: 1558933440
Provider Name (Legal Business Name): ANCORA HOSPICE & PALLIATIVE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 E FRANKLIN RD STE 140
MERIDIAN ID
83642-2914
US

IV. Provider business mailing address

660 E FRANKLIN RD STE 140
MERIDIAN ID
83642-2914
US

V. Phone/Fax

Practice location:
  • Phone: 208-992-2672
  • Fax: 208-992-2673
Mailing address:
  • Phone: 208-452-2672
  • Fax: 208-452-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BILLY GALLIGAR
Title or Position: CMO
Credential: MD
Phone: 208-452-2672