Provider Demographics
NPI:1619286218
Name:RENAISSANCE HOSPICE AND PALLIATIVE CARE, LLC
Entity type:Organization
Organization Name:RENAISSANCE HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-362-5780
Mailing Address - Street 1:2655 CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8479
Mailing Address - Country:US
Mailing Address - Phone:956-362-5780
Mailing Address - Fax:956-362-5789
Practice Address - Street 1:2655 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8479
Practice Address - Country:US
Practice Address - Phone:956-362-5780
Practice Address - Fax:956-362-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026207Medicaid