Healthcare Provider Details

I. General information

NPI: 1114930328
Provider Name (Legal Business Name): ST JOSEPH HOSPICE & PALLIATIVE CARE OF MONROE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 HUDSON CIR SUITE 3
MONROE LA
71201-3538
US

IV. Provider business mailing address

10615 JEFFERSON HWY
BATON ROUGE LA
70809-7230
US

V. Phone/Fax

Practice location:
  • Phone: 318-372-6831
  • Fax: 225-757-1104
Mailing address:
  • Phone: 225-769-2449
  • Fax: 225-757-1104

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: MR. PATRICK T MITCHELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-769-2449