NPIMap

Organization Active NPI

Harbor Hospice of Waco LP

  • Community Based Hospice Care Agency
  • Waco, TX
National Provider Identifier
1407285596
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HARBOR HOSPICE OF WACO LP
Practice address
510 N Valley Mills Dr Ste 306
Waco, TX 76710-6076
Phone
(254) 218-4290
Fax
(254) 730-7256
NPI assigned
Nov 8, 2013
Last updated
Jun 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Authorized official

Name
Karen Carter
Title
Exec Admin Assistant
Phone
(409) 730-2046

Specialties & licenses 1

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

Addresses

Primary practice location

510 N Valley Mills Dr Ste 306
Waco, TX 76710-6076

Mailing address

3406 College St
Suite 200
Beaumont, TX 77701-4612
Phone (409) 813-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150508000776 TX Part A Provider - Hospice 8022337328 Practice locations: Waco, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407285596. Details of each certification follow.

Hospice certification: CCN 741673

Legal name
HARBOR HOSPICE OF WACO LP
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 20, 2017
Last certification
Nov 17, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
OtherProprietary
Incorporated
Aug 20, 2013 in TX
Enrollment address
510 N Valley Mills Dr
Ste 306
Waco, TX 76710-6076

Care Compare: Hospice

Medicare Care Compare
Listed as
Harbor Hospice of Waco, LPCCN 741673 · All quality measures
Ownership
For-Profit
Certified
Jun 20, 2017
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

208 N Bryan Ave
Ste 12
Bryan, TX 77803

1701 Southwest Pkwy
Ste 104
College Station, TX 77840
Phone (409) 813-2332

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Karen Carter Individual W-2 Managing Employee Feb 1, 2019
Bryan Gaspard Individual W-2 Managing Employee Feb 1, 2014
Theresa Cousins Individual W-2 Managing Employee Feb 1, 2014
Arfeen Properties, L.P. Organization, Beaumont, TX 5% Or Greater Direct Ownership Interest Feb 1, 2014
HHCS Managers LLC Organization, Beaumont, TX LLC General Partnership Interest Feb 1, 2014 1%
Qamar U Arfeen Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2014 49.5%
Kelley L Arfeen Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2014 49.5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 45

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 45

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1407285596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-2332",
            "fax_number": "409-232-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N VALLEY MILLS DR STE 306",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106076",
            "telephone_number": "254-218-4290",
            "fax_number": "254-730-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF WACO LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXEC ADMIN ASSISTANT",
        "authorized_official_telephone_number": "409-730-2046"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.