Provider Demographics
NPI:1639381932
Name:HOSPICE FAMILY ALLIANCE, LLC
Entity Type:Organization
Organization Name:HOSPICE FAMILY ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-329-9300
Mailing Address - Street 1:111 HUDSON LN STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5862
Mailing Address - Country:US
Mailing Address - Phone:318-329-9300
Mailing Address - Fax:318-329-9658
Practice Address - Street 1:111 HUDSON LN STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5862
Practice Address - Country:US
Practice Address - Phone:318-329-9300
Practice Address - Fax:318-329-9658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA182251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1527173Medicaid
LA191622Medicare ID - Type UnspecifiedPROVIDER NUMBER