Provider Demographics
NPI:1922503358
Name:AVE MARIA HOSPICE OF FREDERICKSBURG, LLC
Entity Type:Organization
Organization Name:AVE MARIA HOSPICE OF FREDERICKSBURG, LLC
Other - Org Name:AVE MARIA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:830-329-7141
Mailing Address - Street 1:P.O. BOX 3445
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78625
Mailing Address - Country:US
Mailing Address - Phone:830-329-7141
Mailing Address - Fax:
Practice Address - Street 1:204 S. ADAMS ST. #A
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624
Practice Address - Country:US
Practice Address - Phone:830-329-7141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based