GARDENDALE HOSPICE LLC NPI 1679695597

NPI Information

NPI: 1679695597
Provider Name: GARDENDALE HOSPICE LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 45D1068708

Address:
4101 MCEWEN RD STE 260
DALLAS, TX
ZIP 75244
Phone: (214) 357-9200
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GARDENDALE HOSPICE LLC is a hospice care community based in Dallas, TX. GARDENDALE HOSPICE LLC NPI is 1679695597. The provider is registered as an organization entity type.

The provider's business location address is:

4101 MCEWEN RD STE 260
DALLAS, TX
ZIP 75244-112
Phone: (214) 357-9200
Fax: (214) 357-9202

The provider's authorized official is Jesus Manuel Barragan .
The authorized official title is Ceo / President & Administrator and has the following contact phone number (214) 357-9200.

The CLIA number assigned to this NPI record is 45D1068708 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		11204	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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