# PRTRIO HOSPICE - RURAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417361445
- **Authorized official:** HAITHAM JIFI BAHLOOL MD (PRESIDENT)
- **Authorized official phone:** (361) 779-5456

## Contact information

- **Practice address:** 5920 SARATOGA BLVD, SUITE 420, CORPUS CHRISTI, TX 78414-4103
- **Practice address phone:** (361) 779-5456
- **Practice address fax:** (361) 991-0181
- **Mailing address:** 304 E SAN PATRICIO AVE, MATHIS, TX 78368-2350
- **Mailing address phone:** (361) 779-5456
- **Mailing address fax:** (361) 991-0181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/18/2014
- **Last updated:** 06/18/2014