Organization
JORDAN'S CROSSING HOSPICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BECKI D PRUDHOME RN, CHPN, CHA (CLINICAL DIRECTOR/ADMIN/CO OWNER)
(318) 631-6789
Entity
Organization
Contact information
Practice address
624 TRAVIS ST, SUITE 700, SHREVEPORT, LA 71101-3013
(318) 631-6789
(318) 631-6727
Mailing address
624 TRAVIS ST, SUITE 700, SHREVEPORT, LA 71101-3013
(318) 631-6789
(318) 631-6727
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
176
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1584215
—
LA
Enumeration date
07/03/2006
Last updated
08/21/2012
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