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NPI Code Detail

MEDICARE: BLUE STREAM HOSPICE LLC

MEDICARE: BLUE STREAM HOSPICE LLC
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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1144073479
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE STREAM HOSPICE LLC
Provider Business Mailing Address
First Line : 315 W ALABAMA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5161
Country : US
Telephone Number : 281-509-3924
Fax Number :
Provider Business Practice Location Address
First Line : 315 W ALABAMA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5161
Country : US
Telephone Number : 281-509-3924
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KENYATTA L HOLMES
Credential : RN
Telephone Number : 281-509-3924
Provider Enumeration Date : 04/08/2024
Last Update Date : 04/08/2024

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Directions to “BLUE STREAM HOSPICE LLC ” Practice Location

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