Provider Demographics
NPI:1790155794
Name:CONCORD HOSPICE, LLC
Entity Type:Organization
Organization Name:CONCORD HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNAN JAYASINGH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:469-600-6565
Mailing Address - Street 1:719 N CROCKETT ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-4979
Mailing Address - Country:US
Mailing Address - Phone:469-906-2000
Mailing Address - Fax:469-906-2021
Practice Address - Street 1:719 N CROCKETT ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-4979
Practice Address - Country:US
Practice Address - Phone:469-906-2000
Practice Address - Fax:469-906-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based