Healthcare Provider Details

I. General information

NPI: 1457507444
Provider Name (Legal Business Name): HARBOR HOSPICE OF BAYTOWN, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 JAMES BOWIE DR., SUITE D-111
BAYTOWN TX
77520
US

IV. Provider business mailing address

PO BOX 23077
BEAUMONT TX
77720-3077
US

V. Phone/Fax

Practice location:
  • Phone: 281-427-3800
  • Fax: 281-427-3855
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-813-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number67-1645
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number012378
License Number State

VIII. Authorized Official

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