Healthcare Provider Details

I. General information

NPI: 1033558705
Provider Name (Legal Business Name): ST. JOSEPH HOSPICE OF SOUTH ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 MIDTOWN PARK W UNIT B
MOBILE AL
36606-4139
US

IV. Provider business mailing address

10615 JEFFERSON HWY
BATON ROUGE LA
70809-7230
US

V. Phone/Fax

Practice location:
  • Phone: 251-675-7555
  • Fax: 251-675-1541
Mailing address:
  • Phone: 225-368-3181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICK MITCHELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-368-3181