Graben Palliative Hospice Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GRABEN PALLIATIVE HOSPICE CARE LLC

Practice address

3414 Willow Fin Way
Richmond, TX 77406-1789

Phone

(240) 821-3373

NPI assigned

Feb 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Benedict Tabi

Title

Administrator

Phone

(240) 821-3373

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN A91728

Legal name

GRABEN PALLIATIVE HOSPICE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 16, 2024

Last certification

Mar 20, 2024

Organization structure

LLCProprietary

Enrollment address

3414 Willow Fin Way
Richmond, TX 77406-1789

Listed as

Graben Palliative Hospice Care LLCCCN A91728

Certified

Apr 16, 2024

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Sophie Mbua, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
  • NPI 1811534902

  W-2 Managing Employee

  CMS ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1053019745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 WILLOW FIN WAY",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 WILLOW FIN WAY",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061789",
            "telephone_number": "240-821-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRABEN PALLIATIVE HOSPICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "TABI",
        "authorized_official_first_name": "BENEDICT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "240-821-3373"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Richmond, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.