Healthcare Provider Details

I. General information

NPI: 1912081217
Provider Name (Legal Business Name): COMMUNITY CARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 W THOMAS ST SUITE A
HAMMOND LA
70401-3062
US

IV. Provider business mailing address

1007 W THOMAS ST SUITE A
HAMMOND LA
70401-3062
US

V. Phone/Fax

Practice location:
  • Phone: 985-340-1880
  • Fax: 985-340-7872
Mailing address:
  • Phone: 985-340-1880
  • Fax: 985-340-7872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNON DILLON
Title or Position: OWNER
Credential:
Phone: 985-340-1880