Provider Demographics
NPI:1538517883
Name:PALLADIUM HOSPICE AND PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:PALLADIUM HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN-MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEACHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-767-4837
Mailing Address - Street 1:993 TOMMY MUNRO DR STE C
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2133
Mailing Address - Country:US
Mailing Address - Phone:228-207-0390
Mailing Address - Fax:
Practice Address - Street 1:993 TOMMY MUNRO DR STE C
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2133
Practice Address - Country:US
Practice Address - Phone:228-207-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORIANNA INVESTMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based