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General NPI Number Information
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NPI Number | 1902872450
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Entity Type | Organization
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Legal Business Name | SOUTHEAST LOUISIANA HOSPICE
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1406B AVENUE F
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City | BOGALUSA
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State | LA
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Zip | 70427-4341
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Country | US
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Telephone | 985-735-5293
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Fax | 985-732-9193
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Provider Business Mailing Address
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Address Line | PO BOX 816 1406-B AVENUE F
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City | BOGALUSA
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State | LA
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Zip | 70429-0816
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Country | US
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Telephone | 985-735-5293
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Fax | 985-732-9193
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KAY D. KING
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Credential | RN
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Telephone | 985-735-5529
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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 | 151
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License Number State | LA
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