Provider Demographics
NPI:1497463806
Name:ELIGHT HOSPICE LLC
Entity Type:Organization
Organization Name:ELIGHT HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHENGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHAMD
Authorized Official - Phone:281-513-2529
Mailing Address - Street 1:2530 SUNRISE HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3247
Mailing Address - Country:US
Mailing Address - Phone:281-513-2529
Mailing Address - Fax:
Practice Address - Street 1:6464 SAVOY DR STE 730
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3389
Practice Address - Country:US
Practice Address - Phone:903-423-7452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based