| Entity Name: | CATHOLIC HOSPICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 09 Oct 1987 (37 years ago) |
| Document Number: | N22920 |
| FEI/EIN Number | 650062530 |
| Address: | 14875 NW 77 AVENUE, SUITE 100, MIAMI LAKES, FL, 33014, US |
| Mail Address: | 14875 NW 77 AVENUE, 100, MIAMI LAKES, FL, 33014, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427051325 | 2005-05-24 | 2022-01-07 | 14875 NW 77TH AVE, STUITE 100, MIAMI LAKES, FL, 330142568, US | 14875 NW 77TH AVE, STE 100, MIAMI LAKES, FL, 330142568, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 305-822-2380 |
| Fax | 3058192281 |
Authorized person
| Name | MR. ARISTIDES PALLIN |
| Role | PRESIDENT/CEO |
| Phone | 3058222380 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 5004095 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 087569400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FITZGERALD J. PATRICK Esq. | Agent | J. PATRICK FITZGERALD & ASSOCIATES, P.A., CORAL GABLES, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| FRICK MARY JO CEO | President | CATHOLIC HEALTH SERVICES, INC., LAUDERDALE LAKES, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| LAWSON RALPH E | Chairman | 6041 NW 74 Terrace, PARKLAND, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| LAWSON RALPH E | Director | 6041 NW 74 Terrace, PARKLAND, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| FITZGERALD J. PATRICK SR. | Assistant Secretary | J. PATRICK FITZGERALD & ASSOCIATES, P.A., CORAL GABLES, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| WORLEY, SSJ ELIZABETH ASR. | VCSD | ARCHDIOCESE OF MIAMI, MIAMI SHORES, FL, 33138 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-09-30 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 2015-12-14 | No data | No data |
| AMENDMENT | 2010-04-28 | No data | No data |
| AMENDMENT | 2003-01-07 | No data | No data |
| AMENDMENT | 1998-12-31 | No data | No data |
| AMENDMENT | 1995-10-26 | No data | No data |
| AMENDMENT | 1992-01-06 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1988-06-09 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1988-01-21 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
