Provider Demographics
NPI:1689658023
Name:COMMUNITY HOSPICE LLC
Entity Type:Organization
Organization Name:COMMUNITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-899-2500
Mailing Address - Street 1:3600 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3615
Mailing Address - Country:US
Mailing Address - Phone:504-899-2011
Mailing Address - Fax:504-891-9050
Practice Address - Street 1:3600 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3615
Practice Address - Country:US
Practice Address - Phone:504-899-2011
Practice Address - Fax:504-891-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1580937Medicaid
LA1580937Medicaid