Organization Active NPI

Hospice Care Team, Inc

  • Community Based Hospice Care Agency
  • Lake Jackson, TX
National Provider Identifier
1184626467
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
007658 Issued in TX
Legal business name
HOSPICE CARE TEAM, INC
Practice address
107 West Way
Suite 29
Lake Jackson, TX 77566-5238
Phone
(979) 297-6043
Fax
(979) 297-4752
NPI assigned
Jun 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Deborah K Perryman, LMSW
Title
Executive Director
Phone
(979) 297-6043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 007658 TX Primary

Addresses

Primary practice location

107 West Way
Suite 29
Lake Jackson, TX 77566-5238

Mailing address

107 West Way
Suite 29
Lake Jackson, TX 77566-5238
Phone (979) 297-6043

Other identifiers 1

IdentifierTypeStateIssuer
001003872MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

107 W Way St
Ste 29
Lake Jackson, TX 77566
Phone (979) 297-6043

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2016 Change of OwnershipThis provider was the seller Heart of Texas HospiceCCN 451712, TX, NPI 1275999559

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1184626467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WEST WAY",
            "address_2": "SUITE 29",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665238",
            "telephone_number": "979-297-6043",
            "fax_number": "979-297-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEST WAY",
            "address_2": "SUITE 29",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665238",
            "telephone_number": "979-297-6043",
            "fax_number": "979-297-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE CARE TEAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "PERRYMAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-297-6043",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "007658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003872",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.