Provider Demographics
NPI:1780101642
Name:GODLY HOSPICE AND PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:GODLY HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-628-9951
Mailing Address - Street 1:717 N HARWOOD ST STE 550
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-6540
Mailing Address - Country:US
Mailing Address - Phone:214-628-9951
Mailing Address - Fax:214-389-0976
Practice Address - Street 1:911 W LOOP 281 STE 209
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2908
Practice Address - Country:US
Practice Address - Phone:903-551-3400
Practice Address - Fax:430-240-5055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE OAKS HOSPICE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-23
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based