MEDICARE: CLP REGENCY OF TEXAS, 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
1	251G00000X	Community Based Hospice Care Agency	013855	TX

General Provider Information

NPI Number	:	1245538586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLP REGENCY OF TEXAS, LLC

Provider Business Mailing Address
First Line	:	10 CADILLAC DR
Second Line	:	SUITE 400
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5078
Country	:	US
Telephone Number	:	615-425-5407
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	1717 N. IH35
Second Line	:	SUITE 130
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-2901
Country	:	US
Telephone Number	:	512-246-7127
Fax Number	:	512-246-7048

Authorized Official
Title or Position	:	SVP GENERAL COUNSEL
Name	:	RUSSELL ADKINS
Credential	:
Telephone Number	:	615-309-5668

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	04/10/2018

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