Organization
SUPERIOR HOSPICE OF NORTHWEST LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES G GLADNEY JR. (MANAGING PARTNER)
(318) 281-0078
Entity
Organization
Contact information
Practice address
511 JENKINS ST., SUITE B, MANSFIELD, LA 71052
(318) 872-2000
(318) 872-2001
Mailing address
1523 TEXAS AVE., BASTROP, LA 71220-4043
(318) 281-0078
(318) 281-2753
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
238
LA
251G00000X
Community Based Hospice Care Agency
TBD
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1381179
—
LA
01
—
468572
JOINT COMMISSION HCO ID
—
Enumeration date
07/26/2007
Last updated
05/14/2012
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