Provider Demographics
NPI:1376606376
Name:LIFE'S JOURNEY HOSPICE, L.L.C.
Entity Type:Organization
Organization Name:LIFE'S JOURNEY HOSPICE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRT, RCP
Authorized Official - Phone:918-968-4870
Mailing Address - Street 1:313 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:STROUD
Mailing Address - State:OK
Mailing Address - Zip Code:74079-3642
Mailing Address - Country:US
Mailing Address - Phone:918-968-4870
Mailing Address - Fax:918-968-0464
Practice Address - Street 1:313 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-3642
Practice Address - Country:US
Practice Address - Phone:918-968-4870
Practice Address - Fax:918-968-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4166251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based