MEDICARE: PASSAGES HOSPICE NORTH - NORTHEAST, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	305	LA
2	315D00000X	Inpatient Hospice	83	LA
3	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457429813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSAGES HOSPICE NORTH - NORTHEAST, LLC.

Provider Business Mailing Address
First Line	:	909 ELM ST STE B
Second Line	:
City	:	MINDEN
State	:	LA
Zip	:	71055-2700
Country	:	US
Telephone Number	:	318-387-1115
Fax Number	:	866-981-5917

Provider Business Practice Location Address
First Line	:	1900 AUBURN AVE STE F
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5196
Country	:	US
Telephone Number	:	318-387-1115
Fax Number	:	866-981-5917

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER MCMAHON
Credential	:
Telephone Number	:	504-214-4000

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	04/22/2025

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