Provider Demographics
NPI:1073888269
Name:SOUTHLAND UNITED HOSPICE, INC
Entity Type:Organization
Organization Name:SOUTHLAND UNITED HOSPICE, INC
Other - Org Name:MAGNOLIA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-831-4025
Mailing Address - Street 1:5302 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-2258
Mailing Address - Country:US
Mailing Address - Phone:832-831-4025
Mailing Address - Fax:832-667-8452
Practice Address - Street 1:5302 CANAL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-2258
Practice Address - Country:US
Practice Address - Phone:832-831-4025
Practice Address - Fax:832-667-8452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based