MEDICARE: SOUTHLAND UNITED HOSPICE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1073888269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHLAND UNITED HOSPICE, INC

Provider Business Mailing Address
First Line	:	5302 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-2258
Country	:	US
Telephone Number	:	832-831-4025
Fax Number	:	832-667-8452

Provider Business Practice Location Address
First Line	:	5302 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-2258
Country	:	US
Telephone Number	:	832-831-4025
Fax Number	:	832-667-8452

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY LIVINGSTON
Credential	:
Telephone Number	:	832-831-4025

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	03/24/2016

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