Healthcare Provider Details

I. General information

NPI: 1437840972
Provider Name (Legal Business Name): FIREFLY HOME HEALTH & HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8126 FM 512
WOLFE CITY TX
75496-2488
US

IV. Provider business mailing address

8126 FM 512
WOLFE CITY TX
75496-2488
US

V. Phone/Fax

Practice location:
  • Phone: 903-408-6654
  • Fax: 903-408-6695
Mailing address:
  • Phone: 903-408-6654
  • Fax: 903-408-6695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA GOODWIN
Title or Position: ADMINISTRATOR/NURSING SUPERVISOR
Credential: RN
Phone: 903-408-6654