Provider Demographics
NPI:1518128990
Name:COMPASSIONATE CARE HOSPICE OF SOUTHEASTERN TX, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE OF SOUTHEASTERN TX, LLC
Other - Org Name:AMEDISYS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3020
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:2685 S LOOP 336 W STE A-1
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3754
Practice Address - Country:US
Practice Address - Phone:281-592-2830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671647Medicare Oscar/Certification