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General NPI Number Information
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NPI Number | 1669844288
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Entity Type | Organization
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Legal Business Name | GENTIVA HEALTHCARE
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 8050 EASTEX FWY
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City | BEAUMONT
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State | TX
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Zip | 77708-2403
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Country | US
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Telephone | 409-924-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 8050 EASTEX FWY
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City | BEAUMONT
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State | TX
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Zip | 77708-2403
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Country | US
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Telephone | 409-924-0085
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. AUDRIE PITRE
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Credential | ED
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Telephone | 409-924-0085
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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 | AP129327
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License Number State | TX
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