Provider Demographics
NPI:1912081217
Name:COMMUNITY CARE HOSPICE LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE HOSPICE LLC
Other - Org Name:COMMUNITY CARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-340-1880
Mailing Address - Street 1:1007 W THOMAS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-3062
Mailing Address - Country:US
Mailing Address - Phone:985-340-1880
Mailing Address - Fax:985-340-7872
Practice Address - Street 1:1007 W THOMAS ST
Practice Address - Street 2:SUITE A
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3062
Practice Address - Country:US
Practice Address - Phone:985-340-1880
Practice Address - Fax:985-340-7872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1459810Medicaid
LA19-1633Medicare ID - Type UnspecifiedPROVIDER NUMBER