Provider Demographics
NPI:1770057952
Name:PARADISE HOSPICE CARE INC
Entity type:Organization
Organization Name:PARADISE HOSPICE CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MA
Authorized Official - Phone:469-676-4700
Mailing Address - Street 1:9005 S HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3576
Mailing Address - Country:US
Mailing Address - Phone:469-676-4700
Mailing Address - Fax:469-750-3085
Practice Address - Street 1:899 PRESIDENTIAL DR STE 117
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081
Practice Address - Country:US
Practice Address - Phone:469-676-4700
Practice Address - Fax:469-750-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019319OtherHHSC STATE LICENSE