Provider Demographics
NPI:1518728302
Name:ST. GABRIEL'S HOSPICE & PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:ST. GABRIEL'S HOSPICE & PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:IHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-319-7868
Mailing Address - Street 1:4517 WESTBURY DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4266
Mailing Address - Country:US
Mailing Address - Phone:817-319-7868
Mailing Address - Fax:
Practice Address - Street 1:7700 E ARAPAHOE RD STE 220
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1268
Practice Address - Country:US
Practice Address - Phone:817-319-7868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based