Healthcare Provider Details

I. General information

NPI: 1407285596
Provider Name (Legal Business Name): HARBOR HOSPICE OF WACO LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N VALLEY MILLS DR STE 306
WACO TX
76710-6076
US

IV. Provider business mailing address

3406 COLLEGE ST SUITE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 254-218-4290
  • Fax: 254-730-7256
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 Number
License Number State

VIII. Authorized Official

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