Basic Information
Provider Information
NPI: 1255331724
EntityType: 2
ReplacementNPI:  
OrganizationName: LIFEPATH HOSPICE AND FAMILY CARE, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CURO HOSPICE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 655 BRAWLEY SCHOOL RD
Address2: SUITE 200
City: MOORESVILLE
State: NC
PostalCode: 281179125
CountryCode: US
TelephoneNumber: 7046642876
FaxNumber: 7046641306
Practice Location
Address1: 5133 S 1500 W
Address2:  
City: RIVERDALE
State: UT
PostalCode: 844053926
CountryCode: US
TelephoneNumber: 8012930444
FaxNumber: 8012639929
Other Information
ProviderEnumerationDate: 07/27/2005
LastUpdateDate: 12/31/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ABELL
AuthorizedOfficialFirstName: DOUGLAS
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: GENERAL COUNSEL/SEC
AuthorizedOfficialTelephone: 7046642876
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X002501UTY AgenciesHospice Care, Community Based 

No ID Information.


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