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General NPI Number Information
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NPI Number | 1679642425
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Entity Type | Organization
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Legal Business Name | STILL WATERS HOSPICE, LLC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 1405 METRO DR STE L
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3452
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Country | US
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Telephone | 318-767-2000
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Fax | 318-442-5766
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Provider Business Mailing Address
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Address Line | 6932 MONROE HWY
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City | BALL
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State | LA
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Zip | 71405-3232
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Country | US
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Telephone | 318-767-2000
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Fax | 318-442-5766
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM WAYNE ZITO II
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Credential |
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Telephone | 318-767-2000
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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 |
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License Number State |
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