Provider Demographics
NPI:1316539273
Name:BIRCH HOSPICE LLC
Entity Type:Organization
Organization Name:BIRCH HOSPICE LLC
Other - Org Name:BIRCH HOSPICE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GLEASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-922-5595
Mailing Address - Street 1:8746 WURZBACH RD STE 201A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1100
Mailing Address - Country:US
Mailing Address - Phone:210-729-1448
Mailing Address - Fax:
Practice Address - Street 1:8746 WURZBACH RD STE 201A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1100
Practice Address - Country:US
Practice Address - Phone:210-729-6922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based