Southeast Texas Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

002033 Issued in TX

Legal business name

SOUTHEAST TEXAS HOSPICE

Practice address

912 W Cherry Ave
Orange, TX 77630-5017

Phone

(409) 886-0622

Fax

(409) 886-0623

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mary McKenna

Title

Executive Director

Phone

(409) 886-0622

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN 451533

Legal name

SOUTHEAST TEXAS HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 2, 1989

Last certification

Jul 27, 2020

Ownership / control type

Non-Profit - Private

Organization structure

CorporationNon-profit

Enrollment address

912 W. Cherry Ave
Orange, TX 77630

Listed as

The Southeast Texas HospiceCCN 451533

Ownership

Non-Profit

Certified

Jun 2, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Wayne Rudeseal, DC

  • Chiropractor
  • Orange, TX
  • NPI 1124105135
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720162506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2385",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776312385",
            "telephone_number": "409-886-0622",
            "fax_number": "409-886-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W CHERRY AVE",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776305017",
            "telephone_number": "409-886-0622",
            "fax_number": "409-886-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "409-886-0622",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "002033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra L. Smith, PTA
• Tina Maria Smith, LPC
• Lisa Marie Richards Snider, M.ED., LPC
• Asem Souman, MD
• Southeast Texas Family Health & Wellness Center
• Venkatesh C. S. Srinibasa Murphy, M. S., PH. D.
• Sabrina Kathlene Standley, LVN
• Step Forward Treatment Center
• Stephen L. Hall D.O.,P.a
• Stonewood Hospice Inc

• Community Based Hospice Care Agency in Orange, TX
• Providers in Orange, 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 Aug 22, 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.