MEDICARE: ALLIANCE HOSPICE 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		TX

General Provider Information

NPI Number	:	1518195114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE HOSPICE LLC.

Provider Business Mailing Address
First Line	:	5304 ALMEDA RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7440
Country	:	US
Telephone Number	:	713-529-1402
Fax Number	:	713-529-1404

Provider Business Practice Location Address
First Line	:	5304 ALMEDA RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7440
Country	:	US
Telephone Number	:	713-529-1402
Fax Number	:	713-529-1404

Authorized Official
Title or Position	:	CEO
Name	:	DWAYNE HARRIS
Credential	:
Telephone Number	:	713-529-1402

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	06/23/2009

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Directions to “ALLIANCE HOSPICE LLC. ” Practice Location

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