Healthcare Provider Details

I. General information

NPI: 1457692139
Provider Name (Legal Business Name): HARBOR HOSPICE OF GEORGETOWN, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16165 RANCH ROAD 620 NORTH SUITE A
AUSTIN TEXAS
78717
UM

IV. Provider business mailing address

3406 COLLEGE ST SUITE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 512-443-7100
  • Fax: 512-443-7109
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-232-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN CARTER
Title or Position: EXEC ADMIN ASST
Credential:
Phone: 409-730-2046