Provider Demographics
NPI:1558376988
Name:AVE MARIA HOSPICE, INC
Entity Type:Organization
Organization Name:AVE MARIA HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:RNBSN
Authorized Official - Phone:830-992-1997
Mailing Address - Street 1:12078 S HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-9461
Mailing Address - Country:US
Mailing Address - Phone:830-997-1709
Mailing Address - Fax:830-257-0468
Practice Address - Street 1:12078 S HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-9461
Practice Address - Country:US
Practice Address - Phone:830-997-1709
Practice Address - Fax:830-257-0468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010620163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty