Organization
LAKE MARTIN HOSPICE LLC.
Active
Other names
IVY CREEK HOSPICE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D BRUCE (CEO)
(256) 825-4785
Entity
Organization
Contact information
Practice address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(256) 825-3272
(256) 825-8578
Mailing address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(256) 825-3272
(256) 825-8578
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PIC1621E
—
AL
Enumeration date
12/22/2006
Last updated
03/29/2018
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