San Agustin Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SAN AGUSTIN HOSPICE, LLC

Practice address

1220 San Agustin Ave
Laredo, TX 78040-6307

Phone

(956) 704-5096

Fax

(956) 441-1751

NPI assigned

Jul 21, 2021

Last updated

Mar 2, 2022By 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

Mr. Eduardo Davila Jr.

Title

Member

Phone

(956) 516-2732

Specialties & licenses 1

Addresses

Other names 1

• Serenity Hospice of Laredo, LLC Former legal business name

Locations

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1811560311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SAN AGUSTIN AVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780406307",
            "telephone_number": "956-704-5096",
            "fax_number": "956-441-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SAN AGUSTIN AVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780406307",
            "telephone_number": "956-704-5096",
            "fax_number": "956-441-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN AGUSTIN HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "956-516-2732",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Hospice of Laredo, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.