Organization
LHCG CLXXII, LLC
Active
Other names
Casa de la Luz Palliative Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1840 S STAPLEY DR STE 225B, MESA, AZ 85204-6685
(480) 801-2416
(480) 801-2417
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251G00000X
Community Based Hospice Care Agency
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/13/2020
Last updated
02/05/2025
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