Provider Demographics
NPI:1457763062
Name:CHARTER HOSPICE INC
Entity Type:Organization
Organization Name:CHARTER HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-502-6535
Mailing Address - Street 1:2665 VILLA CREEK DR
Mailing Address - Street 2:SUITE A260
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7309
Mailing Address - Country:US
Mailing Address - Phone:214-502-6535
Mailing Address - Fax:972-692-8484
Practice Address - Street 1:2665 VILLA CREEK DR
Practice Address - Street 2:SUITE A260
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7309
Practice Address - Country:US
Practice Address - Phone:214-502-6535
Practice Address - Fax:972-692-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based