Provider Demographics
NPI:1437379328
Name:HARBOUR HOSPICE OF BEXAR COUNTY LLC
Entity Type:Organization
Organization Name:HARBOUR HOSPICE OF BEXAR COUNTY LLC
Other - Org Name:HARBOUR HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORCHOW-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-403-9911
Mailing Address - Street 1:12915 JONES MALTSBERGER RD STE 501
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4256
Mailing Address - Country:US
Mailing Address - Phone:210-403-9911
Mailing Address - Fax:210-403-9926
Practice Address - Street 1:12915 JONES MALTSBERGER RD STE 501
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4256
Practice Address - Country:US
Practice Address - Phone:210-403-9911
Practice Address - Fax:210-403-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011557251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671593Medicare Oscar/Certification