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General NPI Number Information
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NPI Number | 1255354189
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Entity Type | Organization
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Legal Business Name | SETON HIGHLAND LAKES HOSPICE LLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 9430 RESEARCH BLVD STE 310
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City | AUSTIN
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State | TX
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Zip | 78759-6586
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Country | US
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Telephone | 512-756-8003
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Fax | 512-756-8046
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Provider Business Mailing Address
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Address Line | 9430 RESEARCH BLVD STE 310
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City | AUSTIN
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State | TX
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Zip | 78759-6586
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Country | US
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Telephone | 512-756-8003
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Fax | 512-756-8046
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Authorized Official
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Title or Position | REGIONAL VP
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Name | ROBERTA ROSE
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Credential | RN, BSN
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Telephone | 512-756-8003
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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 | 016740
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License Number State | TX
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