Provider Demographics
NPI:1548565989
Name:ST JAMES HOSPICE,LLC
Entity type:Organization
Organization Name:ST JAMES HOSPICE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:MELENDEZ
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-687-9045
Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:# 220
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:972-687-9045
Mailing Address - Fax:972-687-9046
Practice Address - Street 1:14275 MIDWAY RD
Practice Address - Street 2:# 220
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3614
Practice Address - Country:US
Practice Address - Phone:972-687-9045
Practice Address - Fax:972-687-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-16
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based