Provider Demographics
NPI:1528563673
Name:COLORADO PALLIATIVE & HOSPICE CARE OF COLORADO SPRINGS LLC
Entity type:Organization
Organization Name:COLORADO PALLIATIVE & HOSPICE CARE OF COLORADO SPRINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUHALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-220-4073
Mailing Address - Street 1:PO BOX 530324
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0324
Mailing Address - Country:US
Mailing Address - Phone:719-419-5595
Mailing Address - Fax:719-359-5452
Practice Address - Street 1:4775 CENTENNIAL BLVD STE 160
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3302
Practice Address - Country:US
Practice Address - Phone:719-419-5595
Practice Address - Fax:719-359-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO061595251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based