Gardendale Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

11204 Issued in TX

Legal business name

GARDENDALE HOSPICE LLC

Practice address

4101 McEwen Rd Ste 260
Dallas, TX 75244-5112

Phone

(214) 357-9200

Fax

(214) 357-9202

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Jesus Manuel Barragan, ADMINISTRATOR

Title

Ceo / President & Administrator

Phone

(214) 357-9200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1679695597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 MCEWEN RD STE 260",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752445112",
            "telephone_number": "214-357-9200",
            "fax_number": "214-357-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MCEWEN RD STE 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445112",
            "telephone_number": "214-357-9200",
            "fax_number": "214-357-9202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "753 W 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Corsicana",
            "state": "TX",
            "postal_code": "751102942",
            "country_code": "US",
            "telephone_number": "903-874-3232",
            "fax_number": "903-874-3235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARDENDALE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BARRAGAN",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "CEO / PRESIDENT & ADMINISTRATOR",
        "authorized_official_telephone_number": "214-357-9200",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "11204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Dallas, TX
• Providers in Dallas, 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 17, 2018; 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.