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Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Countryside Hospice Care Inc

Community Based Hospice Care Agency in La Fayette, GA · enumerated 2006 · authorized official Glen Cavallo, Sr. Vp - Operations.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1265470249

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Countryside Hospice Care Inc
Other name <Unavail>
Parent organization Countryside Hospice Care Inc
Practice address 106 Pearl Dr, Suite 107, La Fayette, GA, 30728
Phone (706) 638-7651
Fax (706) 638-7545
Enumeration date Jun 3, 2006
Last updated in NPPES Feb 16, 2012

Taxonomy & classification

251G00000X Community Based Hospice Care Agency Agencies · License 146142H (GA) Primary

Authorized official

Name Glen Cavallo
Title Sr. Vp - Operations
Phone (479) 996-5900

Other identifiers

Identifier Type State Issuer
00850044A Medicaid GA -
146142H Other GA GEORGIA HOSPICE LICENSE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Countryside Hospice Care Inc?
NPPES lists Glen Cavallo (Sr. Vp - Operations) as the authorized official for this organization.
What is the NPI number for Countryside Hospice Care Inc?
The NPI for Countryside Hospice Care Inc is 1265470249, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-02-16.