Organization Name: | PARTNERS HEALTHCARE GROUP OF LOUISIANA, LLC |
NPI Number: | 1013342583 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROB A RADICS (CEO) |
Mailing Address: | 101 La Rue France Suite 301 Lafayette |
State: | LA US |
Postal Code: | 705083144 |
Phone Number: | 3372641650 |
Fax Number: | 3372641649 |
NPI Enumeration Date: | 09/03/2013 |
NPI Last Update Date: | 09/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 2203781754 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |