Healthcare Provider Details

I. General information

NPI: 1639686256
Provider Name (Legal Business Name): LITTLE LANTERN HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4541 N JOSEY LN STE 110
CARROLLTON TX
75010-4622
US

IV. Provider business mailing address

2705 DAMSEL BELLA BLVD
LEWISVILLE TX
75056-6169
US

V. Phone/Fax

Practice location:
  • Phone: 469-775-9555
  • Fax: 469-788-7800
Mailing address:
  • Phone: 469-788-8588
  • Fax: 469-788-7800

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: BIJU M LUKOSE
Title or Position: CEO
Credential:
Phone: 469-788-8588