MEDICARE: HOSPICE PLUS NORTH EAST 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

General Provider Information

NPI Number	:	1457584633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE PLUS NORTH EAST LLC

Provider Business Mailing Address
First Line	:	5550 HARVEST HILL RD
Second Line	:	SUITE 50
City	:	DALLAS
State	:	TX
Zip	:	75230-1684
Country	:	US
Telephone Number	:	972-385-3988
Fax Number	:	972-385-3977

Provider Business Practice Location Address
First Line	:	5550 HARVEST HILL RD
Second Line	:	SUITE 50
City	:	DALLAS
State	:	TX
Zip	:	75230-1684
Country	:	US
Telephone Number	:	972-385-3988
Fax Number	:	972-385-3977

Authorized Official
Title or Position	:	CEO
Name	:	DR. BRYAN K. WHITE
Credential	:	M.D.
Telephone Number	:	972-385-3988

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	09/03/2009

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