Provider Demographics
NPI:1245277045
Name:FAMILY HOSPICE, LTD.
Entity type:Organization
Organization Name:FAMILY HOSPICE, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:DIRK
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-922-9711
Mailing Address - Street 1:717 N HARWOOD ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-6519
Mailing Address - Country:US
Mailing Address - Phone:214-922-9711
Mailing Address - Fax:214-922-9752
Practice Address - Street 1:4125 S MINGO RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3633
Practice Address - Country:US
Practice Address - Phone:918-622-4828
Practice Address - Fax:918-511-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK004027251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100688470BMedicaid
OK100688470BMedicaid