Provider Demographics
NPI:1093264087
Name:J & J HOMELY HOSPICE AND PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:J & J HOMELY HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:LIBERTY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:W
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-927-4567
Mailing Address - Street 1:4851 MERLOT AVE UNIT 550
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7380
Mailing Address - Country:US
Mailing Address - Phone:214-385-4398
Mailing Address - Fax:214-385-4368
Practice Address - Street 1:4851 MERLOT AVE UNIT 550
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7380
Practice Address - Country:US
Practice Address - Phone:214-385-4398
Practice Address - Fax:214-385-4368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-02
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based