Provider Demographics
NPI:1477257301
Name:NORTH STAR HOSPICE LLC
Entity Type:Organization
Organization Name:NORTH STAR HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-996-3403
Mailing Address - Street 1:1714 COPRA ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77554-6134
Mailing Address - Country:US
Mailing Address - Phone:409-996-3403
Mailing Address - Fax:
Practice Address - Street 1:6012 AVENUE T
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-5434
Practice Address - Country:US
Practice Address - Phone:409-996-3403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based