Provider Demographics
NPI:1144293192
Name:HOSPICE OF NATCHITOCHES, INC.
Entity type:Organization
Organization Name:HOSPICE OF NATCHITOCHES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:SERS
Authorized Official - Last Name:LACOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-214-0944
Mailing Address - Street 1:106 E LULA ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4363
Mailing Address - Country:US
Mailing Address - Phone:337-239-1020
Mailing Address - Fax:337-239-8069
Practice Address - Street 1:106 E LULA ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4363
Practice Address - Country:US
Practice Address - Phone:337-239-1020
Practice Address - Fax:337-239-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA166251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1583944Medicaid
LA191608Medicare Oscar/Certification