Provider Demographics
NPI:1275849333
Name:LIFEPOINTE HOSPICE LLC
Entity Type:Organization
Organization Name:LIFEPOINTE HOSPICE LLC
Other - Org Name:LIFEPOINTE HOSPICE AND HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-731-2893
Mailing Address - Street 1:12425 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-9093
Mailing Address - Country:US
Mailing Address - Phone:281-824-3250
Mailing Address - Fax:281-781-7112
Practice Address - Street 1:12425 ISLAND DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-9093
Practice Address - Country:US
Practice Address - Phone:281-731-2893
Practice Address - Fax:214-420-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013509251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001020774Medicaid
TX747582Medicare PIN