Provider Demographics
NPI:1497006886
Name:HARBOR HOSPICE OF SOUTH DALLAS-FORT WORTH, LP
Entity Type:Organization
Organization Name:HARBOR HOSPICE OF SOUTH DALLAS-FORT WORTH, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ADMIN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-730-2046
Mailing Address - Street 1:3406 COLLEGE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4612
Mailing Address - Country:US
Mailing Address - Phone:409-813-2332
Mailing Address - Fax:409-232-0573
Practice Address - Street 1:2419 COIT RD # SUIEA
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3731
Practice Address - Country:US
Practice Address - Phone:972-943-0349
Practice Address - Fax:972-692-7232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based