Provider Demographics
NPI:1205904661
Name:PASSAGES HOSPICE NORTH - CENTRAL, LLC
Entity type:Organization
Organization Name:PASSAGES HOSPICE NORTH - CENTRAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT HOSPICE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CARLIE
Authorized Official - Middle Name:STEVENSON
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-371-1140
Mailing Address - Street 1:909 ELM ST STE B
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-2700
Mailing Address - Country:US
Mailing Address - Phone:318-371-1140
Mailing Address - Fax:866-230-1701
Practice Address - Street 1:909 ELM ST STE B
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-2700
Practice Address - Country:US
Practice Address - Phone:318-371-1140
Practice Address - Fax:866-230-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
LA71315D00000X
LA2203782457-I315D00000X
LA2203782457251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1580368Medicaid
LA191535Medicare Oscar/Certification