Provider Demographics
NPI:1154976959
Name:SOUTHERN HOSPICE AND PALLIATIVE CARE INC
Entity type:Organization
Organization Name:SOUTHERN HOSPICE AND PALLIATIVE CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOFFI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:346-754-5782
Mailing Address - Street 1:5802 EDEN CREST CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1617
Mailing Address - Country:US
Mailing Address - Phone:281-975-8819
Mailing Address - Fax:
Practice Address - Street 1:1505 HIGHWAY 6 S STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1700
Practice Address - Country:US
Practice Address - Phone:346-754-5782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient