Provider Demographics
NPI:1295297596
Name:BUENA VIDA HOSPICE LLC
Entity type:Organization
Organization Name:BUENA VIDA HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-888-1499
Mailing Address - Street 1:810 HIGHWAY 6 S # 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4025
Mailing Address - Country:US
Mailing Address - Phone:281-888-1499
Mailing Address - Fax:832-550-2636
Practice Address - Street 1:810 HIGHWAY 6 S # 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4025
Practice Address - Country:US
Practice Address - Phone:281-888-1499
Practice Address - Fax:832-550-2636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based