MEDICARE: SAFE SIDE 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

General Provider Information

NPI Number	:	1770248304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE SIDE HOSPICE INC

Provider Business Mailing Address
First Line	:	2522 SHOAL VALLEY LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-2669
Country	:	US
Telephone Number	:	832-208-4577
Fax Number	:

Provider Business Practice Location Address
First Line	:	2522 SHOAL VALLEY LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-2669
Country	:	US
Telephone Number	:	832-208-4577
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GODWIN UGWUOKE
Credential	:
Telephone Number	:	832-208-4577

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	11/08/2021

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Directions to “SAFE SIDE HOSPICE INC ” Practice Location

Language	Start Address	Practice Location

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