Provider Demographics
NPI:1215084520
Name:HEART OF HOSPICE, LLC
Entity type:Organization
Organization Name:HEART OF HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-232-8159
Mailing Address - Street 1:201 W VERMILION ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6847
Mailing Address - Country:US
Mailing Address - Phone:337-232-8159
Mailing Address - Fax:337-232-8160
Practice Address - Street 1:201 W VERMILION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6847
Practice Address - Country:US
Practice Address - Phone:337-232-8159
Practice Address - Fax:337-232-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA288251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========0OtherBLUE CROSS/BLUE SHIELD
LA191638Medicare Oscar/Certification