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General NPI Number Information
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NPI Number | 1558376988
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Entity Type | Organization
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Legal Business Name | AVE MARIA HOSPICE, INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 12078 S HIGHWAY 16
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-9461
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Country | US
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Telephone | 830-997-1709
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Fax | 830-257-0468
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Provider Business Mailing Address
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Address Line | 12078 S HIGHWAY 16
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-9461
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Country | US
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Telephone | 830-997-1709
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Fax | 830-257-0468
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SHIRLEY ANN HIGDON
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Credential | R.N.BSN
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Telephone | 830-992-1997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 010620
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License Number State | TX
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