=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568633220
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELYSIAN HOSPICE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2008
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16750 WESTGROVE DR SUITE 100
-----------------------------------------------------
City | ADDISON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75001-5688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-224-1876
-----------------------------------------------------
Fax | 972-224-1494
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16750 WESTGROVE DR SUITE 100
-----------------------------------------------------
City | ADDISON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75001-5688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-224-1876
-----------------------------------------------------
Fax | 972-224-1494
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ROBIN F UNDERHILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-954-4114
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315D00000X
-----------------------------------------------------
Taxonomy Name | Inpatient Hospice
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------