Provider Demographics
NPI:1265310692
Name:MODEL HOSPICE LLC
Entity type:Organization
Organization Name:MODEL HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VARGHESE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-718-0809
Mailing Address - Street 1:2735 VILLA CREEK DR STE 115M
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7454
Mailing Address - Country:US
Mailing Address - Phone:214-718-0809
Mailing Address - Fax:
Practice Address - Street 1:2735 VILLA CREEK DR STE 115M
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7454
Practice Address - Country:US
Practice Address - Phone:214-718-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based