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Organization

LIFE SOURCE SERVICES, LLC

Active
Other names
Pax Hospice (Madison)
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TONI PARKINSON (AUTHORIZED REPRESENTATIVE)
(601) 709-1408
Entity
Organization

Contact information

Practice address
129 EXECUTIVE DR, SUITE C, MADISON, MS 39110-8473
(601) 898-1510
(601) 898-1560
Mailing address
129 EXECUTIVE DR, SUITE C, MADISON, MS 39110-8473
(601) 898-1510
(601) 898-1560

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
079
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02580708
MS
Enumeration date
05/03/2006
Last updated
01/14/2021
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