Provider Demographics
NPI:1861105306
Name:SACRED HEART HOSPICE LLC
Entity type:Organization
Organization Name:SACRED HEART HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-2400
Mailing Address - Street 1:404 E RAMSEY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4665
Mailing Address - Country:US
Mailing Address - Phone:210-524-2400
Mailing Address - Fax:
Practice Address - Street 1:404 E RAMSEY RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4665
Practice Address - Country:US
Practice Address - Phone:210-524-2400
Practice Address - Fax:210-524-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based