MEDICARE: LIBBYS HEALTHCARE MANAGEMENT,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
1	251G00000X	Community Based Hospice Care Agency	009177	TX

General Provider Information

NPI Number	:	1710061007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBBYS HEALTHCARE MANAGEMENT,INC

Provider Business Mailing Address
First Line	:	6633 BOULEVARD 26
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-1523
Country	:	US
Telephone Number	:	817-498-7733
Fax Number	:	817-498-7733

Provider Business Practice Location Address
First Line	:	6633 BOULEVARD 26
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-1523
Country	:	US
Telephone Number	:	817-498-7733
Fax Number	:	817-498-7733

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MOLLY K ZACHARIA
Credential	:
Telephone Number	:	817-498-7733

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/26/2007

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