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General NPI Number Information
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NPI Number | 1114516705
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Entity Type | Organization
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Legal Business Name | LENITY LIGHT HOSPICE - DALLAS, LLC
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 5802 WATAUGA RD SUITE 100
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City | WATAUGA
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State | TX
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Zip | 76148-3069
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Country | US
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Telephone | 817-406-1500
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Fax | 817-928-5692
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Provider Business Mailing Address
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Address Line | 3306 WENDOVER CT
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City | RICHARDSON
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State | TX
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Zip | 75082-3248
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Country | US
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Telephone | 469-757-1600
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Fax | 469-519-0202
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Authorized Official
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Title or Position | OWNER
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Name | MRS. FATIN QUTOB
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Credential |
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Telephone | 972-854-3424
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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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