Provider Demographics
NPI:1457507444
Name:HARBOR HOSPICE OF BAYTOWN, LP
Entity Type:Organization
Organization Name:HARBOR HOSPICE OF BAYTOWN, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ADMIN ASST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-730-2046
Mailing Address - Street 1:PO BOX 23077
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77720-3077
Mailing Address - Country:US
Mailing Address - Phone:409-813-2332
Mailing Address - Fax:409-813-2340
Practice Address - Street 1:1610 JAMES BOWIE DR.,
Practice Address - Street 2:SUITE D-111
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520
Practice Address - Country:US
Practice Address - Phone:281-427-3800
Practice Address - Fax:281-427-3855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67-1645251G00000X
012378251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012378OtherDADS
45D1097544OtherCLIA
TX001019465Medicaid
TX67-1645Medicare UPIN
TX001019465Medicaid
TX671645Medicare Oscar/Certification