| NPI | 1508136862 |
|---|---|
| Doing Business As | COUNTRYSIDE HOSPICE-DECATUR |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Corporate Secretary 505-821-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based (Licence: AL 01-1579PSL) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |