Provider Demographics
NPI:1497178602
Name:MT ZION HOSPICE SERVICES LLC
Entity type:Organization
Organization Name:MT ZION HOSPICE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:BALAY
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:940-808-0960
Mailing Address - Street 1:1410 ROBINSON RD
Mailing Address - Street 2:UNIT 200
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-2846
Mailing Address - Country:US
Mailing Address - Phone:940-808-0960
Mailing Address - Fax:940-808-0962
Practice Address - Street 1:1410 ROBINSON RD
Practice Address - Street 2:UNIT 200
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-2846
Practice Address - Country:US
Practice Address - Phone:940-808-0960
Practice Address - Fax:940-808-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based