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NPI Code Detail

MEDICARE: LACKLAND HOSPICE LLC

MEDICARE: LACKLAND 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
1251G00000XCommunity Based Hospice Care AgencyTX

General Provider Information

NPI Number : 1730689761
Entity Type Code : Organization
Provider Name (Legal Business Name) : LACKLAND HOSPICE LLC
Provider Business Mailing Address
First Line : 8300 DOUGLAS AVE STE 800
Second Line :
City : DALLAS
State : TX
Zip : 75225-5826
Country : US
Telephone Number : 888-450-2884
Fax Number : 817-632-3225
Provider Business Practice Location Address
First Line : 8300 DOUGLAS AVE STE 800
Second Line :
City : DALLAS
State : TX
Zip : 75225-5826
Country : US
Telephone Number : 888-450-8224
Fax Number : 817-632-3225
Authorized Official
Title or Position : COMPLIANCE OFFICER
Name : VALERIE JO DEWBRE
Credential : RN
Telephone Number : 214-534-0716
Provider Enumeration Date : 02/16/2018
Last Update Date : 10/24/2024

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Directions to “LACKLAND HOSPICE LLC ” Practice Location

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