Provider Demographics
NPI:1114492360
Name:LIFECARE HEALTH VENTURES, LLC
Entity Type:Organization
Organization Name:LIFECARE HEALTH VENTURES, LLC
Other - Org Name:WINGS OVER TEXAS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DILLON
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-774-9154
Mailing Address - Street 1:205 S CADDO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-5504
Mailing Address - Country:US
Mailing Address - Phone:817-774-9154
Mailing Address - Fax:
Practice Address - Street 1:205 S CADDO ST STE 100
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-5504
Practice Address - Country:US
Practice Address - Phone:817-774-9154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based