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COLLABRIA CARE NPI 1023011178


NPI Information

NPI: 1023011178
Provider Name: COLLABRIA CARE

Doing Business As: PROVIDENCE PALLIATIVE CARE NAPA VALLEY

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 05D0930193

Address:
414 S JEFFERSON ST
NAPA, CA
ZIP 94559
Phone: (707) 258-9080
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COLLABRIA CARE is a hospice care community based in Napa, CA. COLLABRIA CARE NPI is 1023011178. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Palliative Care Napa Valley.

The provider's business location address is:

414 S JEFFERSON ST
NAPA, CA
ZIP 94559-515
Phone: (707) 258-9080
Fax: (707) 258-2476

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Assistant Secretary Of Enrollment and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 05D0930193 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 1/16/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251G00000XHospice Care, Community Based100000741CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1HPC01537GMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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