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General NPI Number Information
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NPI Number | 1477919298
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Entity Type | Organization
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Legal Business Name | ROCKWAL HOSPICE INC
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Dates
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Enumeration Date | 01/08/2016
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 10935 ESTATE LN SUITE S 400 D
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City | DALLAS
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State | TX
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Zip | 75238-2316
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Country | US
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Telephone | 972-288-2706
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Fax | 972-288-2707
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Provider Business Mailing Address
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Address Line | 10935 ESTATE LN SUITE S 400 D
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City | DALLAS
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State | TX
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Zip | 75238-2316
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Country | US
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Telephone | 972-288-2706
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Fax | 972-288-2707
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Authorized Official
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Title or Position | OWNER
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Name | MR. WESLY MATHEW
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Credential | ADMINISTRATOR
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Telephone | 214-929-7614
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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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