Healthcare Provider Details

I. General information

NPI: 1629367750
Provider Name (Legal Business Name): DEL CORAZON HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 SAINT MICHAELS DR SUITE 207
SANTA FE NM
87505-7641
US

IV. Provider business mailing address

811 SAINT MICHAELS DR SUITE 207
SANTA FE NM
87505-7641
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-2049
  • Fax: 505-982-2930
Mailing address:
  • Phone: 505-988-2049
  • Fax: 505-982-2930

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: MR. DAVID STEPHEN RODRIGUEZ
Title or Position: PRESIDENT
Credential: L.P.N., L.N.H.A.
Phone: 505-988-2049