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General NPI Number Information
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NPI Number | 1699350090
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Entity Type | Organization
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Legal Business Name | AVANT HOSPICE, LLC
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 130 LYNN CREEK DR
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City | MABANK
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State | TX
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Zip | 75156-9606
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Country | US
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Telephone | 214-458-5199
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Fax |
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Provider Business Mailing Address
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Address Line | 130 LYNN CREEK DR
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City | MABANK
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State | TX
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Zip | 75156-9606
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY CARLISLE
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Credential |
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Telephone | 214-458-5199
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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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