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General NPI Number Information
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NPI Number | 1134490238
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Entity Type | Organization
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Legal Business Name | HOSPICE 2012, LLC
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 4333 AMERICAN WAY
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City | BATON ROUGE
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State | LA
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Zip | 70816-0402
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Country | US
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Telephone | 225-753-1495
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Fax | 225-753-1301
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Provider Business Mailing Address
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Address Line | 4333 AMERICAN WAY
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City | BATON ROUGE
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State | LA
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Zip | 70816-0402
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Country | US
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Telephone | 225-753-1495
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Fax | 225-753-1301
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Authorized Official
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Title or Position | CEO
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Name | MRS. DANA L MCBRIDE
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Credential | RN
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Telephone | 225-753-1495
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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 | 306
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License Number State | LA
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