MEDICARE: GOLDEN HOSPICE AND PALLIATIVE CARE, 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	:	1952995607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HOSPICE AND PALLIATIVE CARE, INC.

Provider Business Mailing Address
First Line	:	633 E FERNHURST DR STE 502
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1589
Country	:	US
Telephone Number	:	346-640-4353
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 E FERNHURST DR STE 502
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-1589
Country	:	US
Telephone Number	:	346-640-4353
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHNSON AMBROISE
Credential	:
Telephone Number	:	346-640-4353

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	10/19/2023

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