Healthcare Provider Details

I. General information

NPI: 1518269885
Provider Name (Legal Business Name): LHCG XXII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MCFARLAND BLVD
NORTHPORT AL
35476-3348
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 205-633-3705
  • Fax: 205-633-3755
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-233-5764

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: MR. JOSHUA PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307