Provider Demographics
NPI:1093969677
Name:AMERACARE FAMILY HOSPICE, LLC
Entity Type:Organization
Organization Name:AMERACARE FAMILY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-635-6900
Mailing Address - Street 1:303 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3153
Mailing Address - Country:US
Mailing Address - Phone:985-386-7800
Mailing Address - Fax:985-635-6936
Practice Address - Street 1:303 W. 21ST AVENUE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-893-3301
Practice Address - Fax:985-893-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA151251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA151OtherDHH-LICENSE
LA19D1032115OtherCLIA
LA19D1032115OtherCLIA