MEDICARE: HOSPICE CARE SERVICES,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	85	LA

General Provider Information

NPI Number	:	1407800907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE CARE SERVICES,LLC

Provider Business Mailing Address
First Line	:	PO BOX 268
Second Line	:	303 PRAIRIE ST
City	:	WINNSBORO
State	:	LA
Zip	:	71295-0268
Country	:	US
Telephone Number	:	318-435-8502
Fax Number	:	318-435-8504

Provider Business Practice Location Address
First Line	:	303 PRAIRIE ST
Second Line	:	303 PRAIRIE ST
City	:	WINNSBORO
State	:	LA
Zip	:	71295-2732
Country	:	US
Telephone Number	:	318-435-8502
Fax Number	:	318-435-8504

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RICHARD DARRELL MAHONEY
Credential	:
Telephone Number	:	318-435-8502

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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