Provider Demographics
NPI:1184181182
Name:HEART OF HOSPICE LLC
Entity Type:Organization
Organization Name:HEART OF HOSPICE LLC
Other - Org Name:HEART OF HOSPICE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHASSIN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-443-4154
Practice Address - Street 1:6425 YOUREE DR STE 580
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4656
Practice Address - Country:US
Practice Address - Phone:318-865-7177
Practice Address - Fax:318-404-1346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART OF HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-26
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPENDINGMedicaid