Provider Demographics
NPI:1770154601
Name:SANGRE DE CRISTO COMMUNITY CARE HOSPICE EAST
Entity type:Organization
Organization Name:SANGRE DE CRISTO COMMUNITY CARE HOSPICE EAST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGGING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-542-0032
Mailing Address - Street 1:207 COLORADO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1517
Mailing Address - Country:US
Mailing Address - Phone:719-383-9085
Mailing Address - Fax:719-283-1175
Practice Address - Street 1:207 COLORADO AVE STE A
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-1517
Practice Address - Country:US
Practice Address - Phone:719-383-9085
Practice Address - Fax:719-283-1175
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANGRE DE CRISTO HOSPICE & PALLIATIVE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-01
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19715501Medicaid