Provider Demographics
NPI:1407178023
Name:TRADITIONS HOSPICE OF GALVESTON, LLC
Entity Type:Organization
Organization Name:TRADITIONS HOSPICE OF GALVESTON, LLC
Other - Org Name:TRADITIONS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-704-6547
Mailing Address - Street 1:150 4TH AVE N STE 2300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2466
Mailing Address - Country:US
Mailing Address - Phone:979-705-6547
Mailing Address - Fax:
Practice Address - Street 1:700 ROCKMEAD DR STE 170
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2111
Practice Address - Country:US
Practice Address - Phone:281-919-1780
Practice Address - Fax:281-781-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001020774Medicaid
TX017848OtherTEXAS DEPT. OF AGING AND DISABILITY SERVICES- LICENSE
TX671684Medicare PIN