MEDICARE: OPTIMUM HOSPICE 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

General Provider Information

NPI Number	:	1679198808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM HOSPICE LLC

Provider Business Mailing Address
First Line	:	127 W BROAD ST STE 800
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-4297
Country	:	US
Telephone Number	:	337-439-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2245 KELLER WAY STE 150
Second Line	:	UNIT H
City	:	CARROLLTON
State	:	TX
Zip	:	75006-2515
Country	:	US
Telephone Number	:	945-229-6950
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KENDALL ALLEN BROUSSARD
Credential	:
Telephone Number	:	337-439-6600

Provider Enumeration Date	:	06/12/2020
Last Update Date	:	02/04/2026

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Directions to “OPTIMUM HOSPICE LLC ” Practice Location

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