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General NPI Number Information
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NPI Number | 1093598971
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Entity Type | Organization
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Legal Business Name | INDIGO HOSPICE AND PALLIATIVE CARE LLC
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 7207 REGENCY SQUARE BLVD STE 260-26
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City | HOUSTON
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State | TX
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Zip | 77036-3188
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Country | US
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Telephone | 832-715-3592
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Fax |
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Provider Business Mailing Address
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Address Line | 7207 REGENCY SQUARE BLVD
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City | HOUSTON
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State | TX
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Zip | 77036-3188
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | MAHA TAYEBELASMA
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Credential |
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Telephone | 281-460-7349
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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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