Provider Demographics
NPI:1275107211
Name:CELESTIAL CARE HOSPICE LLC
Entity Type:Organization
Organization Name:CELESTIAL CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTCHEBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-583-8876
Mailing Address - Street 1:1700 W GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7305
Mailing Address - Country:US
Mailing Address - Phone:956-583-8876
Mailing Address - Fax:956-580-2356
Practice Address - Street 1:1700 W GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7305
Practice Address - Country:US
Practice Address - Phone:956-583-8876
Practice Address - Fax:956-580-2356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based