Organization
GAMBLE HOSPICE CARE NORTHWEST, LLC
Active
Other names
Aime Hospice Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization
Contact information
Practice address
8950 E KINGS HWY, SHREVEPORT, LA 71115
(318) 861-2150
(318) 861-2157
Mailing address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7600
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2203781702
LA
315D00000X
Inpatient Hospice
150
LA
315D00000X
Inpatient Hospice
2203781702-I
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581089
—
LA
Enumeration date
06/09/2006
Last updated
03/03/2020
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