Organization
J. DONALD PERSICH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUE C MAY CHPLN, CHA (ADMINISTRATOR)
(504) 729-6920
Entity
Organization
Contact information
Practice address
1221 S. CLEARVIEW PKWY, FOURTH FLOOR, CANON HOSPICE, JEFFERSON, LA 70121
(504) 818-2723
(504) 734-3509
Mailing address
4609 GARY MIKEL AVE, METAIRIE, LA 70002-1459
(504) 887-5010
(504) 734-3509
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006826
MEDICAL LICENSE NUMBER STATE OF LOUISIANA
LA
Enumeration date
11/18/2013
Last updated
11/18/2013
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