Provider Demographics
NPI:1407800907
Name:HOSPICE CARE SERVICES,LLC
Entity Type:Organization
Organization Name:HOSPICE CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DARRELL
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-435-8502
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:303 PRAIRIE ST
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-0268
Mailing Address - Country:US
Mailing Address - Phone:318-435-8502
Mailing Address - Fax:318-435-8504
Practice Address - Street 1:303 PRAIRIE ST
Practice Address - Street 2:303 PRAIRIE ST
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2732
Practice Address - Country:US
Practice Address - Phone:318-435-8502
Practice Address - Fax:318-435-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA85251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA191557Medicare ID - Type UnspecifiedPROVIDER #