Provider Demographics
NPI:1942547195
Name:JASMINE WHITE HOSPICE LLC
Entity Type:Organization
Organization Name:JASMINE WHITE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GOODING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-443-7789
Mailing Address - Street 1:4444 CORONA DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4324
Mailing Address - Country:US
Mailing Address - Phone:361-443-7789
Mailing Address - Fax:
Practice Address - Street 1:4444 CORONA DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4324
Practice Address - Country:US
Practice Address - Phone:361-443-7789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based