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NPI Code Detail

MEDICARE: ST. JOHNS HOSPICE LLC

MEDICARE: ST. JOHNS HOSPICE 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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1982266300
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. JOHNS HOSPICE LLC
Provider Business Mailing Address
First Line : 4414 CENTERVIEW STE 208
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-1432
Country : US
Telephone Number : 210-718-0551
Fax Number : 210-718-0554
Provider Business Practice Location Address
First Line : 4414 CENTERVIEW STE 208
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-1432
Country : US
Telephone Number : 210-718-0551
Fax Number : 210-718-0554
Authorized Official
Title or Position : VP OF OPERATIONS
Name : BREEZIE JEAN LISKEY
Credential :
Telephone Number : 801-485-6166
Provider Enumeration Date : 07/05/2019
Last Update Date : 03/13/2026

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Directions to “ST. JOHNS HOSPICE LLC ” Practice Location

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