Provider Demographics
NPI:1245761212
Name:HEART OF HOSPICE LLC
Entity Type:Organization
Organization Name:HEART OF HOSPICE LLC
Other - Org Name:
Other - Org Type:
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 1:810 E SUNFLOWER RD STE 100C
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2828
Practice Address - Country:US
Practice Address - Phone:662-350-0557
Practice Address - Fax:662-350-0481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART OF HOSPICE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-22
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS195251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based