Provider Demographics
NPI:1225538648
Name:LENA'S LOVE HOSPICE LLC
Entity Type:Organization
Organization Name:LENA'S LOVE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTWINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-610-9727
Mailing Address - Street 1:PO BOX 591518
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0125
Mailing Address - Country:US
Mailing Address - Phone:210-610-9727
Mailing Address - Fax:830-438-1266
Practice Address - Street 1:26114 RAVEN FEATHER
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-6017
Practice Address - Country:US
Practice Address - Phone:210-610-9727
Practice Address - Fax:830-438-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based