A Hospice Boutique LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

A HOSPICE BOUTIQUE LLC

Practice address

4823 Bismark Dr
Dallas, TX 75216-7712

Phone

(214) 789-4038

Fax

(877) 257-3774

NPI assigned

May 25, 2021

Last updated

May 25, 2021By 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

Tracy L King

Title

Administrator

Phone

(214) 435-1683

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1386219046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 BISMARK DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167712",
            "telephone_number": "214-789-4038",
            "fax_number": "877-257-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 BISMARK DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167712",
            "telephone_number": "214-789-4038",
            "fax_number": "877-257-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A HOSPICE BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-435-1683"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.