Provider Demographics
NPI:1679681233
Name:AMENITY HOSPICE, INC
Entity Type:Organization
Organization Name:AMENITY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT- CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:956-361-5100
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0031
Mailing Address - Country:US
Mailing Address - Phone:956-361-5100
Mailing Address - Fax:956-361-5106
Practice Address - Street 1:625 N SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4670
Practice Address - Country:US
Practice Address - Phone:956-361-5100
Practice Address - Fax:956-361-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010588251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671566Medicare Oscar/Certification