Healthcare Provider Details

I. General information

NPI: 1033880075
Provider Name (Legal Business Name): PEACEFUL HOPE HOSPICE AND PALLIATIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 AVENUE G
DALLAS TX
75203-3901
US

IV. Provider business mailing address

621 AVENUE G
DALLAS TX
75203-3901
US

V. Phone/Fax

Practice location:
  • Phone: 214-866-9270
  • Fax:
Mailing address:
  • Phone: 214-866-9270
  • Fax:

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: PEACE OKIENYA
Title or Position: P/ADMIN/DON
Credential:
Phone: 214-866-9270