Provider Demographics
NPI:1316166739
Name:MORIAH HOSPICE AND PALLIATIVE CARE,LLC,INC.
Entity type:Organization
Organization Name:MORIAH HOSPICE AND PALLIATIVE CARE,LLC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-843-8766
Mailing Address - Street 1:904 SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-3528
Mailing Address - Country:US
Mailing Address - Phone:662-843-8766
Mailing Address - Fax:
Practice Address - Street 1:904 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-3528
Practice Address - Country:US
Practice Address - Phone:662-843-8766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based