Organization Name: | LAKESIDE HOSPICE, LLC |
NPI Number: | 1073841417 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKI BURNS (MANAGER) |
Mailing Address: | 5105 W Napoleon Ave Metairie |
State: | LA US |
Postal Code: | 700012233 |
Phone Number: | 5044566011 |
Fax Number: | 5044566964 |
NPI Enumeration Date: | 11/23/2009 |
NPI Last Update Date: | 11/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |