Provider Demographics
NPI:1760506000
Name:SOLACE HOSPICE, LLC
Entity Type:Organization
Organization Name:SOLACE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:RAMIREZ
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-813-1212
Mailing Address - Street 1:8596 E 101ST ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7034
Mailing Address - Country:US
Mailing Address - Phone:918-394-4444
Mailing Address - Fax:918-394-4455
Practice Address - Street 1:8596 E 101ST ST
Practice Address - Street 2:SUITE G
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7034
Practice Address - Country:US
Practice Address - Phone:918-394-4444
Practice Address - Fax:918-394-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based