Healthcare Provider Details

I. General information

NPI: 1043264682
Provider Name (Legal Business Name): HARBOR HOSPICE OF BEAUMONT LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 NORTH MAJOR DRIVE
BEAUMONT TX
77713-9575
US

IV. Provider business mailing address

POST OFFICE BOX 23077
BEAUMONT TX
77720-3077
US

V. Phone/Fax

Practice location:
  • Phone: 409-840-5640
  • Fax: 409-232-0567
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-838-7598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number009979
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number67-1511
License Number StateTX

VIII. Authorized Official

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