Provider Demographics
NPI:1265730832
Name:LHCG XXVIII, LLC
Entity type:Organization
Organization Name:LHCG XXVIII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOVEMBER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1037
Mailing Address - Fax:337-233-5764
Practice Address - Street 1:817 N SECTION ST
Practice Address - Street 2:SUITE A
Practice Address - City:SULLIVAN
Practice Address - State:IN
Practice Address - Zip Code:47882-7605
Practice Address - Country:US
Practice Address - Phone:812-268-4311
Practice Address - Fax:812-268-2654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157542Medicare Oscar/Certification