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
Update your record
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