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NPI Code Detail

MEDICARE: LIFE CHOICE HOSPICE OF COLORADO II, LLC

MEDICARE: LIFE CHOICE HOSPICE OF COLORADO II, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1932642683
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CHOICE HOSPICE OF COLORADO II, LLC
Provider Business Mailing Address
First Line : 655 SOUTHPOINTE CT
Second Line : SUITE 201
City : COLORADO SPRINGS
State : CO
Zip : 80906-3859
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5475 TECH CENTER DR STE 105
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-2336
Country : US
Telephone Number : 719-493-9579
Fax Number :
Authorized Official
Title or Position : SVP GENERAL COUNSEL
Name : RUSSELL ADKINS
Credential :
Telephone Number : 615-309-5668
Provider Enumeration Date : 11/29/2016
Last Update Date : 02/26/2019

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