Organization
ASERACARE HOSPICE - JACKSON, LLC
Active
Other names
AseraCare Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KUSSEROW (PRESIDENT)
(225) 292-2031
Entity
Organization
Contact information
Practice address
4115 N COLLEGE AVE, JACKSON, AL 36545-2022
(251) 246-4113
Mailing address
3854 AMERICAN WAY STE A, BATON ROUGE, LA 70816-4897
(225) 292-2031
(225) 295-9678
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012-484
BCBS
—
05
—
PIC-1562E
—
AL
Enumeration date
06/01/2006
Last updated
07/06/2020
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