Provider Demographics
NPI:1215759980
Name:NEW AGE HOSPICE PALLIATIVE, LLC
Entity type:Organization
Organization Name:NEW AGE HOSPICE PALLIATIVE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-390-4040
Mailing Address - Street 1:4050 RIO BRAVO ST STE 100A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1036
Mailing Address - Country:US
Mailing Address - Phone:915-533-0999
Mailing Address - Fax:915-533-0997
Practice Address - Street 1:4050 RIO BRAVO ST STE 100A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1036
Practice Address - Country:US
Practice Address - Phone:915-533-0999
Practice Address - Fax:915-533-0997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW AGE HOSPICE PALLIATIVE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-24
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018567OtherLICENSE