Provider Demographics
NPI:1043264682
Name:HARBOR HOSPICE OF BEAUMONT LP
Entity Type:Organization
Organization Name:HARBOR HOSPICE OF BEAUMONT LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ADMIN ASST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-730-2046
Mailing Address - Street 1:POST OFFICE BOX 23077
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77720-3077
Mailing Address - Country:US
Mailing Address - Phone:409-813-2332
Mailing Address - Fax:409-838-7598
Practice Address - Street 1:2450 NORTH MAJOR DRIVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-9575
Practice Address - Country:US
Practice Address - Phone:409-840-5640
Practice Address - Fax:409-232-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67-1511251G00000X
TX009979251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013914Medicaid
TX009979OtherTXDADS
TX671511Medicare Oscar/Certification
TX009979OtherTXDADS