Provider Demographics
NPI:1962405506
Name:COMPASSIONATE CARE HOSPICE OF DELAWARE, LLC
Entity type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE OF DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3803
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:609-239-2096
Practice Address - Street 1:111 CONTINENTAL DR STE 407
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4332
Practice Address - Country:US
Practice Address - Phone:302-993-9090
Practice Address - Fax:023-993-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000552953Medicaid
DE081504Medicare Oscar/Certification