Provider Demographics
NPI:1164970802
Name:ENDEAVOR HOSPICE LLC
Entity Type:Organization
Organization Name:ENDEAVOR HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-870-5178
Mailing Address - Street 1:3458 SAINT CLOUD CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2634
Mailing Address - Country:US
Mailing Address - Phone:214-870-5178
Mailing Address - Fax:214-352-6136
Practice Address - Street 1:3458 SAINT CLOUD CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2634
Practice Address - Country:US
Practice Address - Phone:214-870-5178
Practice Address - Fax:214-352-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based