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General NPI Number Information
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NPI Number | 1730689761
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Entity Type | Organization
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Legal Business Name | LACKLAND HOSPICE LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 8300 DOUGLAS AVE STE 800
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City | DALLAS
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State | TX
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Zip | 75225-5826
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Country | US
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Telephone | 888-450-8224
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Fax | 817-632-3225
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Provider Business Mailing Address
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Address Line | 8300 DOUGLAS AVE STE 800
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City | DALLAS
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State | TX
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Zip | 75225-5826
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Country | US
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Telephone | 888-450-2884
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Fax | 817-632-3225
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | VALERIE JO DEWBRE
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Credential | RN
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Telephone | 214-534-0716
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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 | TX
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