Angel Care Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ANGEL CARE HOSPICE LLC

Doing business as

Angel Care Hospice

Practice address

702 Fair Park Dr
Suite 102
Henderson, TX 75654-3266

Phone

(903) 657-2461

Fax

(903) 657-8796

NPI assigned

Mar 12, 2008

Last updated

Mar 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Burt Allen King

Title

Chief Financial Officer

Phone

(903) 657-8969

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Angel Care Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326219874. Details of each certification follow.

• CCN 671638 Hospice · Active · Details

Hospice certification: CCN 671638

Legal name

ANGEL CARE HOSPICE L.L.C.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 17, 2009

Last certification

Jun 10, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Dec 3, 2007 in TX

Enrollment address

702 Fair Park Drive
Suite 102
Henderson, TX 75654-3062

Listed as

Angel Care Hospice LLCCCN 671638 · All quality measures

Ownership

For-Profit

Certified

Sep 17, 2009

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Deepti A Govathoti, MD

  • Family Medicine Physician
  • Carthage, TX
  • NPI 1316190754

  Hospice

  Care Compare affiliation
• Brenda M Vozza, MD

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1588616676

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1326219874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 FAIR PARK DR",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756543266",
            "telephone_number": "903-657-2461",
            "fax_number": "903-657-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 FAIR PARK DR",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756543266",
            "telephone_number": "903-657-2461",
            "fax_number": "903-657-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL CARE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "BURT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "903-657-8969"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Meredith D Arnall, MD
• Chelsey Maerie Arterberry
• Daniel Beghab Asongwe, PHARMD
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• Assisted Living Concepts Inc (Azalea House)

• Community Based Hospice Care Agency in Henderson, TX
• Providers in Henderson, 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 Mar 4, 2015; 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.