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General NPI Number Information
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NPI Number | 1851797765
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Entity Type | Organization
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Legal Business Name | ST. JOHN HOSPICE INC.
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 14228 MIDWAY RD SUITE 130
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City | DALLAS
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State | TX
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Zip | 75244-3656
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Country | US
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Telephone | 734-255-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 14228 MIDWAY RD SUITE 130
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City | DALLAS
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State | TX
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Zip | 75244-3656
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Country | US
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Telephone | 734-255-2505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SALEEM SIDDIQUI
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Credential |
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Telephone | 734-255-2505
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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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