Provider Demographics
NPI:1083204903
Name:SOLEMNITY HOSPICE LLC
Entity Type:Organization
Organization Name:SOLEMNITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/SUP NURSE
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-543-6341
Mailing Address - Street 1:520 CENTRAL PKWY E STE 220
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5584
Mailing Address - Country:US
Mailing Address - Phone:469-626-0041
Mailing Address - Fax:
Practice Address - Street 1:520 CENTRAL PKWY E STE 220
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5584
Practice Address - Country:US
Practice Address - Phone:469-626-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty