MEDICARE: ADVANCED HOLISTIC PALLIATIVE CARE LLC

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	:	1053076380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HOLISTIC PALLIATIVE CARE LLC

Provider Business Mailing Address
First Line	:	7322 SOUTHWEST FWY STE 645 RM F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-2065
Country	:	US
Telephone Number	:	832-419-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7322 SOUTHWEST FWY STE 645 RM F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-2065
Country	:	US
Telephone Number	:	832-419-3500
Fax Number	:

Authorized Official
Title or Position	:	CEO/CFO
Name	:	MRS. ADEJUMOKE OSHINUGA
Credential	:	LVN
Telephone Number	:	832-419-3500

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	04/02/2022

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