Healthcare Provider Details

I. General information

NPI: 1326219874
Provider Name (Legal Business Name): ANGEL CARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 FAIR PARK DR SUITE 102
HENDERSON TX
75654-3266
US

IV. Provider business mailing address

702 FAIR PARK DR SUITE 102
HENDERSON TX
75654-3266
US

V. Phone/Fax

Practice location:
  • Phone: 903-657-2461
  • Fax: 903-657-8796
Mailing address:
  • Phone: 903-657-2461
  • Fax: 903-657-8796

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: BURT ALLEN KING
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 903-657-8969