Provider Demographics
NPI:1164637914
Name:HEART OF HOSPICE OF ALEXANDRIA LLC
Entity Type:Organization
Organization Name:HEART OF HOSPICE OF ALEXANDRIA LLC
Other - Org Name:HEART OF HOSPICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-251-9781
Mailing Address - Street 1:102 WINDHAM CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5482
Mailing Address - Country:US
Mailing Address - Phone:337-251-9781
Mailing Address - Fax:866-235-7765
Practice Address - Street 1:102 WINDHAM CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5482
Practice Address - Country:US
Practice Address - Phone:337-251-9781
Practice Address - Fax:866-235-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based