Provider Demographics
NPI:1902253032
Name:DIRECT HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:DIRECT HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-385-6931
Mailing Address - Street 1:8150 N CENTRAL EXPY STE M2060
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1999
Mailing Address - Country:US
Mailing Address - Phone:713-385-6931
Mailing Address - Fax:
Practice Address - Street 1:2855 MANGUM RD STE 563
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7486
Practice Address - Country:US
Practice Address - Phone:832-649-4236
Practice Address - Fax:866-481-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32060128058OtherTAX ID