Provider Demographics
NPI:1982879367
Name:THE CONNECTICUT HOSPICE, INC.
Entity type:Organization
Organization Name:THE CONNECTICUT HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GILHULY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-315-7633
Mailing Address - Street 1:100 DOUBLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4909
Mailing Address - Country:US
Mailing Address - Phone:203-315-7500
Mailing Address - Fax:203-315-7614
Practice Address - Street 1:100 DOUBLE BEACH RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4909
Practice Address - Country:US
Practice Address - Phone:203-315-7500
Practice Address - Fax:203-315-7614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008004671Medicaid