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General NPI Number Information
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NPI Number | 1144868746
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Entity Type | Organization
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Legal Business Name | GREEN RIVER HOSPICE
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 78150 CALLE TAMPICO STE 205B
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City | LA QUINTA
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State | CA
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Zip | 92253-2907
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Country | US
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Telephone | 760-683-2272
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Fax | 760-683-2245
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Provider Business Mailing Address
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Address Line | 78150 CALLE TAMPICO STE 205B
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City | LA QUINTA
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State | CA
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Zip | 92253-2907
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Country | US
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Telephone | 760-683-2272
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Fax | 760-683-2245
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Authorized Official
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Title or Position | PRESIDENT/FOUNDER
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Name | OLARONKE O CHAMPION
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Credential | RN BSN MBA
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Telephone | 708-261-6487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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