MEDICARE: SAINT BENEDICT 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	:	1174982383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT BENEDICT HOSPICE INC,

Provider Business Mailing Address
First Line	:	10707 CORPORATE DR STE 102
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-4001
Country	:	US
Telephone Number	:	713-261-9571
Fax Number	:	281-564-7326

Provider Business Practice Location Address
First Line	:	10707 CORPORATE DR STE 102
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-4001
Country	:	US
Telephone Number	:	713-261-9571
Fax Number	:	281-564-7326

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOEL S ADA
Credential	:
Telephone Number	:	713-261-9571

Provider Enumeration Date	:	02/16/2016
Last Update Date	:	05/12/2017

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Directions to “SAINT BENEDICT HOSPICE INC, ” Practice Location

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