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General NPI Number Information
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NPI Number | 1275608614
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Entity Type | Organization
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Legal Business Name | MADRONE HOSPICE, INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 255 COLLIER CIR
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City | YREKA
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State | CA
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Zip | 96097-2276
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Country | US
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Telephone | 530-842-3160
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Fax | 530-842-6412
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Provider Business Mailing Address
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Address Line | 255 COLLIER CIR
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City | YREKA
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State | CA
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Zip | 96097-2276
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Country | US
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Telephone | 530-842-3160
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Fax | 530-842-6412
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | AUDREY FLOWER
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Credential |
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Telephone | 530-842-3160
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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 | CA
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