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General NPI Number Information
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NPI Number | 1164800207
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Entity Type | Organization
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Legal Business Name | SERVING HEARTS HEALTHCARE GROUP, LLC
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 10142 ANTELOPE WAY
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City | FORNEY
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State | TX
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Zip | 75126-7878
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Country | US
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Telephone | 972-754-4305
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Fax |
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Provider Business Mailing Address
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Address Line | 10142 ANTELOPE WAY
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City | FORNEY
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State | TX
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Zip | 75126-7878
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Country | US
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Telephone | 972-754-4305
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | JAMES HOLLOMAN
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Credential |
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Telephone | 972-754-4305
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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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