=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144115155
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARBOR HOSPICE OF NACOGDOCHES LP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2025
-----------------------------------------------------
Last Update Date | 06/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1023 N MOUND ST STE G
-----------------------------------------------------
City | NACOGDOCHES
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75961-4453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-234-8170
-----------------------------------------------------
Fax | 936-800-4568
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3406 COLLEGE ST STE 200
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77701-4612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-730-2046
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXEC ADMIN ASST
-----------------------------------------------------
Name | KAREN CARTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 409-730-2046
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------