Contract Details
Ancillary Care Services
Facility name
Hospice Select
Provider ID
P000005703
NPI
1952505240
Tax ID
260165005
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
9550 Forest Lane Suite 511
Dallas, TX 75243
United States
County
Dallas
Phone
2142219216 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Hospice
Map
Address