Provider Demographics
NPI:1629806740
Name:PROTEAM HOSPICE LLC
Entity type:Organization
Organization Name:PROTEAM HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-272-8824
Mailing Address - Street 1:10935 ESTATE LN STE 190
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2371
Mailing Address - Country:US
Mailing Address - Phone:214-272-8824
Mailing Address - Fax:
Practice Address - Street 1:10935 ESTATE LN STE 190
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2371
Practice Address - Country:US
Practice Address - Phone:214-272-8824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based