Provider Demographics
NPI:1033558705
Name:ST. JOSEPH HOSPICE OF SOUTH ALABAMA, LLC
Entity Type:Organization
Organization Name:ST. JOSEPH HOSPICE OF SOUTH ALABAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-368-3181
Mailing Address - Street 1:10615 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7230
Mailing Address - Country:US
Mailing Address - Phone:225-368-3181
Mailing Address - Fax:
Practice Address - Street 1:23 MIDTOWN PARK W UNIT B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4139
Practice Address - Country:US
Practice Address - Phone:251-675-7555
Practice Address - Fax:251-675-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based