Provider Demographics
NPI:1013342583
Name:PARTNERS HEALTHCARE GROUP OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:PARTNERS HEALTHCARE GROUP OF LOUISIANA, LLC
Other - Org Name:PARAMOUNT HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:A
Authorized Official - Last Name:RADICS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-692-4417
Mailing Address - Street 1:3525 PIEDMONT RD NE
Mailing Address - Street 2:SUITE 8-515
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1578
Mailing Address - Country:US
Mailing Address - Phone:404-692-4417
Mailing Address - Fax:404-287-2880
Practice Address - Street 1:101 LA RUE FRANCE
Practice Address - Street 2:SUITE 301
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3144
Practice Address - Country:US
Practice Address - Phone:337-264-1650
Practice Address - Fax:337-264-1649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203781754251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based