MEDICARE: J & J HOMELY HOSPICE AND 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	:	1093264087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J & J HOMELY HOSPICE AND PALLIATIVE CARE LLC

Provider Business Mailing Address
First Line	:	4851 MERLOT AVE UNIT 550
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-7380
Country	:	US
Telephone Number	:	214-385-4398
Fax Number	:	214-385-4368

Provider Business Practice Location Address
First Line	:	4851 MERLOT AVE UNIT 550
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-7380
Country	:	US
Telephone Number	:	214-385-4398
Fax Number	:	214-385-4368

Authorized Official
Title or Position	:	AUTHORIZED MANAGER
Name	:	PHILLIP W CATES
Credential	:
Telephone Number	:	214-927-4567

Provider Enumeration Date	:	10/02/2016
Last Update Date	:	11/18/2023

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