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General NPI Number Information
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NPI Number | 1548359144
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Entity Type | Organization
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Legal Business Name | BRENTWOOD HOSPICE, LLC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 1250 E COPELAND RD STE 260
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City | ARLINGTON
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State | TX
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Zip | 76011-1345
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Country | US
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Telephone | 214-275-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 600 E WHALEY ST
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City | LONGVIEW
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State | TX
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Zip | 75601-6525
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Country | US
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Telephone | 903-230-7670
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Fax | 903-230-7696
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | CYNTHIA A CALLOWAY
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Credential | RN
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Telephone | 903-681-7406
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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 | 010526
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License Number State | TX
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