MEDICARE: LIBRA 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	010386	TX

General Provider Information

NPI Number	:	1477594810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBRA HOSPICE INC.

Provider Business Mailing Address
First Line	:	440 BENMAR DR
Second Line	:	3100
City	:	HOUSTON
State	:	TX
Zip	:	77060-3165
Country	:	US
Telephone Number	:	281-261-6562
Fax Number	:	281-403-2072

Provider Business Practice Location Address
First Line	:	440 BENMAR DR
Second Line	:	3100
City	:	HOUSTON
State	:	TX
Zip	:	77060-3165
Country	:	US
Telephone Number	:	281-261-6562
Fax Number	:	281-403-2072

Authorized Official
Title or Position	:	OWNER
Name	:	UMAR IMARENEZOR
Credential	:
Telephone Number	:	281-261-6562

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/22/2020

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