Provider Demographics
NPI:1265107825
Name:SACRED GIFT SYCAMORE HOSPICE LLC
Entity type:Organization
Organization Name:SACRED GIFT SYCAMORE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAUGHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:832-405-1671
Mailing Address - Street 1:22944 SEBASTIAN DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-5943
Mailing Address - Country:US
Mailing Address - Phone:832-405-1671
Mailing Address - Fax:
Practice Address - Street 1:6201 BONHOMME RD STE 470N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4494
Practice Address - Country:US
Practice Address - Phone:832-405-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based