Autumncare Health Services LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AUTUMNCARE HEALTH SERVICES LLC

Practice address

10701 Corporate Dr Ste 340-105
Stafford, TX 77477-4096

Phone

(713) 557-3296

Fax

(281) 709-6221

NPI assigned

Nov 22, 2016

Organization subpart

No

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

Authorized official

Name

Gloria Glover

Title

Member

Phone

(713) 557-3296

Specialties & licenses 1

Addresses

Other names 1

• AutumnCare Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN 741698

Legal name

AUTUMNCARE HEALTH SERVICES LLC

Doing business as

AUTUMNCARE HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 1, 2017

Last certification

Jun 24, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Nov 18, 2016 in TX

Enrollment address

10701 Corporate Dr
Ste 340-105
Stafford, TX 77477-4096

Listed as

Autumncare HospiceCCN 741698

Ownership

For-Profit

Certified

Dec 1, 2017

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 2

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.

• Tristan Montrale Washington, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1790196616

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Tristan Montrale Washington, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1790196616

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1366985376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 340-105",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774096",
            "telephone_number": "713-557-3296",
            "fax_number": "281-709-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 340-105",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774096",
            "telephone_number": "713-557-3296",
            "fax_number": "281-709-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMNCARE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "713-557-3296"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AutumnCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AutumnCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mercedes August, M.A. CCC-SLP
• Nina Austin, CCC-SLP
• Authorbelly Motors
• Carrie Louise Auxier
• Avery Care Services,Inc
• Awesome Health Inc
• Awesome Health Inc
• Selda Ayik

• Community Based Hospice Care Agency in Stafford, TX
• Providers in Stafford, 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 Apr 29, 2020; 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.