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General NPI Number Information
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NPI Number | 1063470847
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Entity Type | Organization
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Legal Business Name | LIFEPATH HOSPICE CARE SERVICES, LLC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1500 N MARKET ST SUITE B 108
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City | SHREVEPORT
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State | LA
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Zip | 71107-6537
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Country | US
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Telephone | 318-222-5711
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Fax | 318-222-5715
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Provider Business Mailing Address
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Address Line | 1500 N MARKET ST SUITE B 108
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City | SHREVEPORT
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State | LA
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Zip | 71107-6537
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Country | US
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Telephone | 318-222-5711
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Fax | 318-222-5715
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MRS. RANDY BELTON
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Credential |
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Telephone | 601-709-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 125
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License Number State | LA
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