Provider Demographics
NPI:1417162504
Name:RESOLUTIONS HOSPICE - AUSTIN LLC
Entity Type:Organization
Organization Name:RESOLUTIONS HOSPICE - AUSTIN LLC
Other - Org Name:RESOLUTIONS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOI
Authorized Official - Middle Name:
Authorized Official - Last Name:BODINE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-384-4207
Mailing Address - Street 1:1101 ARROW POINT DR STE 301
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7740
Mailing Address - Country:US
Mailing Address - Phone:512-343-5555
Mailing Address - Fax:512-628-6183
Practice Address - Street 1:11825 BUCKNER ROAD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-1716
Practice Address - Country:US
Practice Address - Phone:512-343-5555
Practice Address - Fax:512-628-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX011453251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001018041Medicaid