Healthcare Provider Details

I. General information

NPI: 1093004178
Provider Name (Legal Business Name): HARBOR HOSPICE OF HOUSTON, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 SPACE PARK DR STE C285
HOUSTON TX
77058-3480
US

IV. Provider business mailing address

3406 COLLEGE ST # 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 281-461-6109
  • Fax: 281-461-6038
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-232-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number14077
License Number StateTX

VIII. Authorized Official

Name: KAREN CARTER
Title or Position: EXEC ADMIN ASSTS
Credential:
Phone: 409-730-2046