Healthcare Provider Details

I. General information

NPI: 1225534662
Provider Name (Legal Business Name): LHCG XII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 AMBASSADOR CAFFERY PKWY FL 5
LAFAYETTE LA
70506-5906
US

IV. Provider business mailing address

1000 CHINABERRY DR STE 200
BOSSIER CITY LA
71111-2443
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-8180
  • Fax: 337-233-5764
Mailing address:
  • Phone: 318-684-6050
  • Fax: 318-684-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRIS FOX
Title or Position: GROUP PRESIDENT
Credential:
Phone: 337-247-1801