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NPI Code Detail

MEDICARE: AUTUMN JOURNEY HOSPICE, INC.

MEDICARE: AUTUMN JOURNEY HOSPICE, INC.
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
1251G00000XCommunity Based Hospice Care Agency009696TX

General Provider Information

NPI Number : 1235121484
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTUMN JOURNEY HOSPICE, INC.
Provider Business Mailing Address
First Line : 5347 SPRING VALLEY RD
Second Line :
City : DALLAS
State : TX
Zip : 75254-3009
Country : US
Telephone Number : 972-233-0525
Fax Number : 72-233-0553
Provider Business Practice Location Address
First Line : 5347 SPRING VALLEY RD
Second Line :
City : DALLAS
State : TX
Zip : 75254-3009
Country : US
Telephone Number : 972-233-0525
Fax Number : 72-233-0553
Authorized Official
Title or Position : PRESIDENT
Name : MR. RONALD E. HOLLINGSWORTH
Credential :
Telephone Number : 972-233-0525
Provider Enumeration Date : 08/15/2005
Last Update Date : 08/22/2020

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Directions to “AUTUMN JOURNEY HOSPICE, INC. ” Practice Location

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