Healthcare Provider Details

I. General information

NPI: 1588671614
Provider Name (Legal Business Name): HOSPICE OF THE HEART, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 SOUTH SAN JACINTO
WHITNEY TX
76692
US

IV. Provider business mailing address

PO BOX 2081
WHITNEY TX
76692-5081
US

V. Phone/Fax

Practice location:
  • Phone: 254-694-6009
  • Fax:
Mailing address:
  • Phone: 254-694-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number004211
License Number StateTX

VIII. Authorized Official

Name: PENNY JOHNSON
Title or Position: ADMINISTATOR
Credential:
Phone: 254-694-6009