Organization
COUNTRY TRAILS HOSPICE,LTD.
Active
Organization
COUNTRY TRAILS HOSPICE,LTD.
Active
Other names
Autumn Wood Hospice Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A. MARINICK (PRESIDENT OF THE GENERAL PARTNER)
(903) 962-7595
Entity
Organization
Contact information
Practice address
121 E FRANK ST, GRAND SALINE, TX 75140-1823
(903) 962-7597
(903) 962-3406
Mailing address
PO BOX 588, GRAND SALINE, TX 75140-0588
(903) 962-7597
(903) 962-3406
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67-1567
MEDICARE PROVIDER NUMBER
TX
Enumeration date
08/23/2006
Last updated
02/17/2011
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