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General NPI Number Information
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NPI Number | 1578075891
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Entity Type | Organization
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Legal Business Name | LHCG CXXXVI LLC
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 2030 HAMILTON PLACE BLVD STE 130
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6123
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Country | US
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Telephone | 423-386-1061
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Fax | 423-485-6363
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-233-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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