Organization
DIERKSEN HOSPICE LLC
Active
Organization
DIERKSEN HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN DIERKSEN (CEO)
(903) 277-9471
Entity
Organization
Contact information
Practice address
121 E FRANK ST, GRAND SALINE, TX 75140-1823
(903) 962-7597
(903) 962-3406
Mailing address
1006 WESTLAWN DR, TEXARKANA, TX 75501-4069
(903) 794-4389
(430) 200-4298
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001028109
—
TX
01
—
016834
DADS
TX
Enumeration date
02/26/2015
Last updated
06/16/2018
Update your record
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