Provider Demographics
NPI:1861632978
Name:NEIGHBORHOOD HOSPICE, LLC
Entity Type:Organization
Organization Name:NEIGHBORHOOD HOSPICE, LLC
Other - Org Name:COMPLETE HOSPICE CARE OF SOUTHERN OKLAHOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-516-5655
Mailing Address - Street 1:9005 S HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3576
Mailing Address - Country:US
Mailing Address - Phone:580-746-2595
Mailing Address - Fax:580-746-2578
Practice Address - Street 1:1 SW 11TH ST STE 120
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3850
Practice Address - Country:US
Practice Address - Phone:580-746-2595
Practice Address - Fax:580-746-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4283251G00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHO4283OtherLICENSE
OKHO4283OtherLICENSE