=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447816087
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUSTIN COMMUNITY HOSPICE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2019
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 223 W ANDERSON LN STE B700
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78752-1237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-354-7222
-----------------------------------------------------
Fax | 512-362-6464
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 223 W ANDERSON LN STE B700
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78752-1237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-374-7222
-----------------------------------------------------
Fax | 512-362-6464
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | THOMAS LLOYD WILSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-354-7222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------