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Organization

SHEPHERD LIVING HOSPICE LLC

Active
Parent organization
SHEPHERD LIVING HOSPICE
Other names
Four Seasons Hospice
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHEPHERD LIVING HOSPICE
Authorized official
MONA TALUKDAR (CEO/OWNER)
(210) 767-3870
Entity
Organization

Contact information

Practice address
15420 NACOGDOCHES RD, SAN ANTONIO, TX 78247
(210) 767-3870
Mailing address
15420 NACOGDOCHES RD, SAN ANTONIO, TX 78247-1106
(210) 767-3870

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
016725
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001029813
TX
01
016725
STATE LICENSE
TX
Enumeration date
09/12/2016
Last updated
04/06/2020
About Stedi
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  • Eligibility checks
  • EDI platform