MEDICARE: INNOVISION HOSPICE CARE, 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	:	1306480694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVISION HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	9900 WESTPARK DR STE 275
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-5285
Country	:	US
Telephone Number	:	832-582-8980
Fax Number	:	832-582-8649

Provider Business Practice Location Address
First Line	:	9900 WESTPARK DR STE 275
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-5285
Country	:	US
Telephone Number	:	832-582-8980
Fax Number	:	832-582-8649

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SALEEM B SHAKOOR
Credential	:
Telephone Number	:	248-866-8745

Provider Enumeration Date	:	10/30/2019
Last Update Date	:	10/30/2019

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