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General NPI Number Information
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NPI Number | 1922503358
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Entity Type | Organization
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Legal Business Name | AVE MARIA HOSPICE OF FREDERICKSBURG, LLC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 204 S. ADAMS ST. #A
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-329-7141
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 3445
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City | FREDERICKSBURG
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State | TX
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Zip | 78625
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Country | US
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Telephone | 830-329-7141
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LUCILLE JUNG
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Credential | LNFA
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Telephone | 830-329-7141
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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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