Provider Demographics
NPI:1538244819
Name:ENVOY HOSPICE, LLC
Entity type:Organization
Organization Name:ENVOY HOSPICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-331-6271
Mailing Address - Street 1:500 FAULCONER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5089
Mailing Address - Country:US
Mailing Address - Phone:434-977-9711
Mailing Address - Fax:434-235-4142
Practice Address - Street 1:14141 SOUTHWEST FWY STE 260
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4763
Practice Address - Country:US
Practice Address - Phone:281-493-9744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX67-1562251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016257Medicaid
TX671562Medicare Oscar/Certification
TX67-1562Medicare PIN
TX671562Medicare Oscar/Certification
TX001016257Medicaid