Healthcare Provider Details

I. General information

NPI: 1184795445
Provider Name (Legal Business Name): JOURNEY HOSPICE OF ALEXANDRIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 PECAN PARK AVE
ALEXANDRIA LA
71303-3361
US

IV. Provider business mailing address

221 PECAN PARK AVE
ALEXANDRIA LA
71303-3361
US

V. Phone/Fax

Practice location:
  • Phone: 318-880-0223
  • Fax:
Mailing address:
  • Phone:
  • 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: BOBBY ROUSE JR.
Title or Position: CFO
Credential:
Phone: 901-937-3060