Provider Demographics
NPI:1164136305
Name:STILL WATERS HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:STILL WATERS HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOVIRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-536-3880
Mailing Address - Street 1:1218 S JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3341
Mailing Address - Country:US
Mailing Address - Phone:832-536-3880
Mailing Address - Fax:
Practice Address - Street 1:1218 S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3341
Practice Address - Country:US
Practice Address - Phone:832-536-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based