Provider Demographics
NPI:1154327575
Name:LION HOSPICE, INC.
Entity Type:Organization
Organization Name:LION HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:817-268-8103
Mailing Address - Street 1:1816 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3066
Mailing Address - Country:US
Mailing Address - Phone:817-268-8103
Mailing Address - Fax:817-282-5967
Practice Address - Street 1:2601 NW EXPRESSWAY
Practice Address - Street 2:STE 910W
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7263
Practice Address - Country:US
Practice Address - Phone:405-842-2215
Practice Address - Fax:405-810-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4139251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371599Medicare ID - Type Unspecified