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General NPI Number Information
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NPI Number | 1043078504
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Entity Type | Organization
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Legal Business Name | LONESTAR LEGACY HOSPICE LLC
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 9206 MCCOMBS ST STE 33
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City | EL PASO
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State | TX
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Zip | 79924-7423
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Country | US
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Telephone | 915-218-5876
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Fax | 915-218-5202
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Provider Business Mailing Address
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Address Line | 5300 TROPICANA AVE
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City | EL PASO
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State | TX
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Zip | 79924-3320
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Country | US
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Telephone | 915-218-5876
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Fax | 915-218-5202
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR
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Name | CRISTAL COKER
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Credential |
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Telephone | 915-218-5876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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