Provider Demographics
NPI:1174827463
Name:SHIELDS HOSPICE SERVICES LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:SHIELDS HOSPICE SERVICES LIMITED LIABILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:CHUKS
Authorized Official - Last Name:ETUOKWU
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:832-498-3420
Mailing Address - Street 1:7203 MENLO CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4984
Mailing Address - Country:US
Mailing Address - Phone:832-460-3271
Mailing Address - Fax:832-460-3277
Practice Address - Street 1:7203 MENLO CREEK CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4984
Practice Address - Country:US
Practice Address - Phone:832-460-3271
Practice Address - Fax:832-460-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based