MEDICARE: SAFEHAVEN HOSPICE OF DALLAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1043520430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFEHAVEN HOSPICE OF DALLAS

Provider Business Mailing Address
First Line	:	3435 ASBURY STREET
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-1844
Country	:	US
Telephone Number	:	214-526-7814
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 ASBURY STREET
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-1844
Country	:	US
Telephone Number	:	214-526-7814
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MRS. RACHNA AGARWAL
Credential	:
Telephone Number	:	214-526-7814

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	10/19/2010

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Directions to “SAFEHAVEN HOSPICE OF DALLAS ” Practice Location

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