Provider Demographics
NPI:1942471230
Name:AUDUBON HOSPICE OF LAFAYETTE, INC
Entity Type:Organization
Organization Name:AUDUBON HOSPICE OF LAFAYETTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:WOODROW
Authorized Official - Last Name:BANKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:225-218-8009
Mailing Address - Street 1:9256 INTERLINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-218-8009
Mailing Address - Fax:225-237-1170
Practice Address - Street 1:221 RUE DE JEAN STE 205
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3283
Practice Address - Country:US
Practice Address - Phone:337-541-1000
Practice Address - Fax:337-236-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based