Organization
HARBOR HOSPICE OF LIBERTY LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN CARTER (EXEC ADMIN ASSISTANT)
(409) 730-2046
Entity
Organization
Contact information
Practice address
623 MAIN ST STE 2, LIBERTY, TX 77575-4848
(936) 641-9431
(936) 641-9187
Mailing address
3406 COLLEGE ST, SUITE 200, BEAUMONT, TX 77701-4612
(409) 813-2332
(409) 838-7598
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014311
TXDADS
TX
01
—
45D2034839
CLIA
TX
01
—
67-1735
MEDICARE PTAN
—
Enumeration date
07/05/2011
Last updated
11/23/2020
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