Provider Demographics
NPI:1427030733
Name:RIVER REGION HOSPICE, LLC
Entity Type:Organization
Organization Name:RIVER REGION HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPN
Authorized Official - Phone:985-331-0101
Mailing Address - Street 1:12715 HIGHWAY 90
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-2205
Mailing Address - Country:US
Mailing Address - Phone:985-331-0101
Mailing Address - Fax:985-331-0070
Practice Address - Street 1:12715 HIGHWAY 90
Practice Address - Street 2:SUITE 220
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-2205
Practice Address - Country:US
Practice Address - Phone:985-331-0101
Practice Address - Fax:985-331-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA88251G00000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251G00000XAgenciesHospice Care, Community Based
Not Answered315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1580490Medicaid
SC191560Medicare ID - Type Unspecified