Provider Demographics
NPI:1487624813
Name:HARRIS HOSPICE, INC.
Entity type:Organization
Organization Name:HARRIS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-353-0800
Mailing Address - Street 1:550 S EDMONDS LN STE 102
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3577
Mailing Address - Country:US
Mailing Address - Phone:972-353-0800
Mailing Address - Fax:972-353-0811
Practice Address - Street 1:550 S EDMONDS LN STE 102
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3577
Practice Address - Country:US
Practice Address - Phone:972-353-0800
Practice Address - Fax:972-353-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX009245251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001019158Medicaid
TX001012754Medicaid