Provider Demographics
NPI:1639356868
Name:MAHOGANY HOSPICE CARE OF LOUISIANA, INC
Entity type:Organization
Organization Name:MAHOGANY HOSPICE CARE OF LOUISIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:337-232-5992
Mailing Address - Street 1:3414 MOSS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-6107
Mailing Address - Country:US
Mailing Address - Phone:337-232-5992
Mailing Address - Fax:337-232-5929
Practice Address - Street 1:3414 MOSS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-6107
Practice Address - Country:US
Practice Address - Phone:337-232-5992
Practice Address - Fax:337-232-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based