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Organization

LAKESHORE HOSPICE ACQUISITION, LLC

Active
Other names
Lakeshore Hospice
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRIS JOSEPH LOPEZ (MEMBER/ADMINISTRATOR)
(985) 549-1877
Entity
Organization

Contact information

Practice address
15781 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 549-1877
(985) 375-1192
Mailing address
15781 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 549-1877
(985) 375-1192

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2203781977
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1580970
LA
01
19-1588
MEDICARE PTAN
LA
Enumeration date
03/07/2006
Last updated
12/24/2014
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