Healthcare Provider Details

I. General information

NPI: 1386622371
Provider Name (Legal Business Name): ST THERESAS HOSPICE & PALLIATIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14777 HIGHWAY 90 FRONTAGE RD
FRANKLIN LA
70538-5113
US

IV. Provider business mailing address

201 W VERMILION ST STE 200
LAFAYETTE LA
70501-6847
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-0262
  • Fax: 337-232-0266
Mailing address:
  • Phone: 337-232-0262
  • Fax: 337-232-0266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number168
License Number StateLA

VIII. Authorized Official

Name: TRACEY ROMERO
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 337-232-0262