Provider Demographics
NPI:1194256883
Name:JOURNEY HOSPICE, LLC
Entity type:Organization
Organization Name:JOURNEY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-455-0101
Mailing Address - Street 1:434 BREESPORT ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2603
Mailing Address - Country:US
Mailing Address - Phone:210-422-9739
Mailing Address - Fax:210-455-0208
Practice Address - Street 1:454 BREESPORT ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2603
Practice Address - Country:US
Practice Address - Phone:210-455-0101
Practice Address - Fax:210-455-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based