Provider Demographics
NPI:1962712885
Name:HOSANNA HOSPICE, LLC
Entity type:Organization
Organization Name:HOSANNA HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-781-9900
Mailing Address - Street 1:219 S CAGE BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4824
Mailing Address - Country:US
Mailing Address - Phone:956-781-9900
Mailing Address - Fax:956-781-9901
Practice Address - Street 1:219 S CAGE BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4824
Practice Address - Country:US
Practice Address - Phone:956-781-9900
Practice Address - Fax:956-781-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012905251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based