Provider Demographics
NPI:1659741411
Name:ABS PALLIATIVE AND HOSPICE CARE LLC
Entity Type:Organization
Organization Name:ABS PALLIATIVE AND HOSPICE CARE LLC
Other - Org Name:THREE OAKS HOSPICE FORT WORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-628-9950
Mailing Address - Street 1:717 N HARWOOD ST STE 550
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-6501
Mailing Address - Country:US
Mailing Address - Phone:214-628-9951
Mailing Address - Fax:214-389-0976
Practice Address - Street 1:500 GRAPEVINE HWY STE 225
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2790
Practice Address - Country:US
Practice Address - Phone:817-328-1628
Practice Address - Fax:817-520-2108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE OAKS HOSPICE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-05
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based