Provider Demographics
NPI:1811670110
Name:SHORELINE HOSPICE CARE LLC
Entity type:Organization
Organization Name:SHORELINE HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-665-6055
Mailing Address - Street 1:4402 BROADWAY BLVD # 14C
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-8263
Mailing Address - Country:US
Mailing Address - Phone:972-665-6055
Mailing Address - Fax:972-665-6066
Practice Address - Street 1:4402 BROADWAY BLVD # 14C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-8263
Practice Address - Country:US
Practice Address - Phone:972-665-6055
Practice Address - Fax:972-665-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based