Provider Demographics
NPI:1932147501
Name:LUTHERAN SUNSET MINISTRIES
Entity Type:Organization
Organization Name:LUTHERAN SUNSET MINISTRIES
Other - Org Name:HOSPICE SUNSET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:GOERDEL
Authorized Official - Suffix:
Authorized Official - Credentials:REVEREND
Authorized Official - Phone:254-675-8637
Mailing Address - Street 1:410 N. AVE G
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-0071
Mailing Address - Country:US
Mailing Address - Phone:254-675-3391
Mailing Address - Fax:254-675-3493
Practice Address - Street 1:410 N AVENUE G
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1530
Practice Address - Country:US
Practice Address - Phone:254-675-3391
Practice Address - Fax:254-675-3493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SUNSET MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001015019Medicaid
TX001015019Medicaid