Provider Demographics
NPI:1144908799
Name:RIO GRANDE HOSPICE LLC
Entity type:Organization
Organization Name:RIO GRANDE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CO-CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-433-9165
Mailing Address - Street 1:4100 OSUNA RD NE STE 105
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4442
Mailing Address - Country:US
Mailing Address - Phone:505-433-9165
Mailing Address - Fax:505-944-9310
Practice Address - Street 1:4100 OSUNA RD NE STE 105
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4442
Practice Address - Country:US
Practice Address - Phone:505-433-9165
Practice Address - Fax:505-944-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based