Basic Information
Provider Information
NPI: 1275068959
EntityType: 2
ReplacementNPI:  
OrganizationName: LHCG XCVIII, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BAPTIST HOME CARE & HOSPICE - NORTH MISSISSIPPI
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 51266
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705051266
CountryCode: US
TelephoneNumber: 3372331307
FaxNumber: 3372335764
Practice Location
Address1: 548 HIGHWAY 6 E
Address2:  
City: BATESVILLE
State: MS
PostalCode: 386063002
CountryCode: US
TelephoneNumber: 6625788402
FaxNumber: 6625788410
Other Information
ProviderEnumerationDate: 05/01/2017
LastUpdateDate: 07/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GACHASSIN
AuthorizedOfficialFirstName: NICHOLAS
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SECRETARY / TREASURER
AuthorizedOfficialTelephone: 3372331307
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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