Organization
HEAVEN;LY HOSPICE@HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OMANA SIMON (ADMINISTRATOR)
(832) 693-6532
Entity
Organization
Contact information
Practice address
445 FM 1092 RD STE 101G, STAFFORD, TX 77477-5453
(281) 969-8491
Mailing address
445 FM 1092 RD STE 101G, STAFFORD, TX 77477-5453
(281) 969-8491
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
14510
TX
286500000X
Military Hospital
0377171-22
TX
Other
Enumeration date
07/22/2006
Last updated
01/28/2013
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