Healthcare Provider Details

I. General information

NPI: 1427650811
Provider Name (Legal Business Name): LHCG CLXXX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 ARCTIC BLVD STE 102
ANCHORAGE AK
99503-5769
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 907-272-1275
  • Fax: 907-272-1311
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-443-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NICHOLAS GACHASSIN III
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 337-233-1307