Provider Demographics
NPI:1861963258
Name:AVENIR HOSPICE CARE LLC
Entity type:Organization
Organization Name:AVENIR HOSPICE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MS
Authorized Official - Phone:940-257-6100
Mailing Address - Street 1:1111 HOLLIDAY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4421
Mailing Address - Country:US
Mailing Address - Phone:940-257-6100
Mailing Address - Fax:940-745-2047
Practice Address - Street 1:1111 HOLLIDAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4421
Practice Address - Country:US
Practice Address - Phone:408-576-1009
Practice Address - Fax:940-745-2047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based