Healthcare Provider Details

I. General information

NPI: 1568889962
Provider Name (Legal Business Name): SHALOM HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 03/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N POST OAK RD
HOUSTON TX
77024-3841
US

IV. Provider business mailing address

720 N POST OAK RD
HOUSTON TX
77024-3841
US

V. Phone/Fax

Practice location:
  • Phone: 281-205-0907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: OLUYEMISI AMOS
Title or Position: OWNER
Credential:
Phone: 713-530-9828