Healthcare Provider Details

I. General information

NPI: 1831158203
Provider Name (Legal Business Name): TRINITY HOSPICE OF TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E HUBBARD ST STE 101
MINERAL WELLS TX
76067-5320
US

IV. Provider business mailing address

PO BOX 4060
MOORESVILLE NC
28117-4060
US

V. Phone/Fax

Practice location:
  • Phone: 940-468-4194
  • Fax: 940-325-3353
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number011458
License Number StateTX

VIII. Authorized Official

Name: MRS. JANET COMBS
Title or Position: VP, LICENSURE
Credential:
Phone: 704-664-2876