Provider Demographics
NPI:1124684196
Name:PRIM PALLIATIVE & HOSPICE CARE INC
Entity type:Organization
Organization Name:PRIM PALLIATIVE & HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALESOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-342-3097
Mailing Address - Street 1:5048 TENNYSON PKWY STE 122
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3088
Mailing Address - Country:US
Mailing Address - Phone:469-342-3097
Mailing Address - Fax:469-277-8468
Practice Address - Street 1:5048 TENNYSON PKWY STE 122
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3088
Practice Address - Country:US
Practice Address - Phone:469-328-7219
Practice Address - Fax:469-277-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based