Provider Demographics
NPI:1710053855
Name:TRIUMPH HOSPICE
Entity Type:Organization
Organization Name:TRIUMPH HOSPICE
Other - Org Name:JOURNEY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-447-0211
Mailing Address - Street 1:17000 PRESTON RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1224
Mailing Address - Country:US
Mailing Address - Phone:972-447-0211
Mailing Address - Fax:972-692-8767
Practice Address - Street 1:17000 PRESTON RD
Practice Address - Street 2:SUITE 350
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1224
Practice Address - Country:US
Practice Address - Phone:972-447-0211
Practice Address - Fax:972-692-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009926251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009926OtherDEPT.AGING&DISABILITY SVS
TX67-1523Medicare ID - Type Unspecified