Provider Demographics
NPI:1275738957
Name:CROSSROADS HOSPICE, LLC
Entity Type:Organization
Organization Name:CROSSROADS HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, DON, ADM
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WESTMORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-878-2182
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:705 BROADWAY ST.
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232
Mailing Address - Country:US
Mailing Address - Phone:318-878-2182
Mailing Address - Fax:318-878-2185
Practice Address - Street 1:702 FIRST STREET
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232
Practice Address - Country:US
Practice Address - Phone:318-878-2182
Practice Address - Fax:318-878-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
LA345251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based