Provider Demographics
NPI:1972175339
Name:DALLASUS HOSPICE LLC
Entity type:Organization
Organization Name:DALLASUS HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:972-979-9454
Mailing Address - Street 1:1218 LUNA LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5231
Mailing Address - Country:US
Mailing Address - Phone:972-979-9454
Mailing Address - Fax:
Practice Address - Street 1:4505 STIRLING DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-7220
Practice Address - Country:US
Practice Address - Phone:972-979-9454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based