Healthcare Provider Details

I. General information

NPI: 1295334365
Provider Name (Legal Business Name): CMSP HOSPICE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N HWY 360 STE 1105B
GRAND PRAIRIE TX
75050-1011
US

IV. Provider business mailing address

2100 N HWY 360 STE 1105B
GRAND PRAIRIE TX
75050-1011
US

V. Phone/Fax

Practice location:
  • Phone: 817-902-5959
  • Fax: 940-233-1049
Mailing address:
  • Phone: 817-902-5959
  • Fax: 940-233-1049

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: MICHAEL NNADI
Title or Position: OWNER
Credential: RN
Phone: 817-902-5959