Provider Demographics
NPI:1700947066
Name:HOSPICE LONGVIEW, INC.
Entity Type:Organization
Organization Name:HOSPICE LONGVIEW, INC.
Other - Org Name:HEART'SWAY HOSPICE OF NORTHEAST TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN BURKLEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-295-1680
Mailing Address - Street 1:PO BOX 5608
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-5608
Mailing Address - Country:US
Mailing Address - Phone:903-295-1680
Mailing Address - Fax:903-295-1690
Practice Address - Street 1:4351 MCCANN RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2907
Practice Address - Country:US
Practice Address - Phone:903-295-1680
Practice Address - Fax:903-295-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002514251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2089Medicaid
TX2089Medicaid