| Organization Name: | HARBOR HOSPICE OF EAST DALLAS-FORT WORTH, LP |
| NPI Number: | 1912258336 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD THIBODAUX (CHIEF DATA OFFICER) |
| Mailing Address: | 2617 Bolton Boone Dr Suite C1 Desoto |
| State: | TX US |
| Postal Code: | 751152074 |
| Phone Number: | 9722960820 |
| Fax Number: | 9722960918 |
| NPI Enumeration Date: | 09/25/2012 |
| NPI Last Update Date: | 05/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |