Healthcare Provider Details

I. General information

NPI: 1093969677
Provider Name (Legal Business Name): AMERACARE FAMILY HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W. 21ST AVENUE
COVINGTON LA
70433
US

IV. Provider business mailing address

303 W 21ST AVE
COVINGTON LA
70433-3153
US

V. Phone/Fax

Practice location:
  • Phone: 985-893-3301
  • Fax: 985-893-3401
Mailing address:
  • Phone: 985-386-7800
  • Fax: 985-635-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number151
License Number StateLA

VIII. Authorized Official

Name: MILTON R MIZE
Title or Position: OWNER/MEMBER
Credential:
Phone: 985-635-6900