Provider Demographics
NPI:1689039364
Name:JOURNEY HOSPICE CARE OF HOUMA LOUISIANA LLC
Entity type:Organization
Organization Name:JOURNEY HOSPICE CARE OF HOUMA LOUISIANA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:770-608-5225
Mailing Address - Street 1:598 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2833
Mailing Address - Country:US
Mailing Address - Phone:985-223-1865
Mailing Address - Fax:985-223-1863
Practice Address - Street 1:598 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2833
Practice Address - Country:US
Practice Address - Phone:985-223-1865
Practice Address - Fax:985-223-1863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
191657Medicare Oscar/Certification