Organization Name: | SANS BOIS HOSPICE, LLC |
NPI Number: | 1063851418 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEREMY WARREN (ADMINISTRATOR) |
Mailing Address: | 1505 E Main St Unit C Stigler |
State: | OK US |
Postal Code: | 744622914 |
Phone Number: | 9189671001 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2013 |
NPI Last Update Date: | 06/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 4290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |