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General NPI Number Information
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NPI Number | 1831860642
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Entity Type | Organization
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Legal Business Name | LHCG CCX, LLC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 8060 SPYGLASS HILL ROAD
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City | VIERA
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State | FL
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Zip | 32940-8119
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Country | US
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Telephone | 321-806-1874
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Fax | 321-806-1875
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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 | 337-443-4154
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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 | 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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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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