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General NPI Number Information
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NPI Number | 1730354440
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Entity Type | Organization
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Legal Business Name | LONE STAR HOSPICE ALLIANCE LLC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 301 MEXICO BLVD SUITE H3A RM 320
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City | BROWNSVILLE
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State | TX
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Zip | 78520-4159
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Country | US
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Telephone | 208-529-0800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3881
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City | IDAHO FALLS
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State | ID
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Zip | 83403-3881
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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 | MEMBER
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Name | ROBERT COLLETTE
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Credential |
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Telephone | 208-529-0800
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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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