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General NPI Number Information
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NPI Number | 1174504708
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Entity Type | Organization
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Legal Business Name | HOSPICE IN THE PINES INC
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 1504 W FRANK AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3314
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Country | US
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Telephone | 936-632-1514
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Fax | 936-632-1582
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Provider Business Mailing Address
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Address Line | 1504 W FRANK AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3314
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Country | US
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Telephone | 936-632-1514
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Fax | 936-632-1582
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Authorized Official
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Title or Position | SENIOR EXECUTIVE DIRECTOR
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Name | MRS. DEMETRESS LASHEL HARRELL
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Credential | MA, DAPA, BSW-LSW
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Telephone | 936-632-1514
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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 | 002060
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License Number State | TX
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