Provider Demographics
NPI:1336508084
Name:LIFEPOINTE HOSPICE DALLAS METROPLEX LLC
Entity Type:Organization
Organization Name:LIFEPOINTE HOSPICE DALLAS METROPLEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:R
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:214-420-4014
Mailing Address - Fax:214-420-4014
Practice Address - Street 1:12810 HILLCREST RD
Practice Address - Street 2:SUITE B-127
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1525
Practice Address - Country:US
Practice Address - Phone:214-420-4014
Practice Address - Fax:214-420-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based