Provider Demographics
NPI:1457304750
Name:GADSDEN HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:GADSDEN HOME CARE SERVICES LLC
Other - Org Name:GADSDEN REGIONAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:82 INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ATTALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35954-3361
Mailing Address - Country:US
Mailing Address - Phone:256-538-7460
Mailing Address - Fax:256-538-0138
Practice Address - Street 1:82 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:ATTALLA
Practice Address - State:AL
Practice Address - Zip Code:35954-3361
Practice Address - Country:US
Practice Address - Phone:256-538-7460
Practice Address - Fax:256-538-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11652251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIC1504EMedicaid
ALPIC1504EMedicaid