NPIMap

Organization Active NPI

Harbor Hospice of Oakdale, LLC

  • Community Based Hospice Care Agency
  • Oakdale, LA
National Provider Identifier
1033313200
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
19-1656 Issued in LA
Legal business name
HARBOR HOSPICE OF OAKDALE, LLC
Practice address
209 N 16TH St
Oakdale, LA 71463-2211
Phone
(318) 335-5029
Fax
(318) 335-5066
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brad Thibodaux
Title
Chief Data Officer
Phone
(409) 813-2332

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X PENDING
Community Based Hospice Care Agency 251G00000X 19-1656 LA Primary

Addresses

Primary practice location

209 N 16TH St
Oakdale, LA 71463-2211

Mailing address

3406 College St
Suite 200
Beaumont, TX 77701-4612
Phone (409) 813-2332

Other identifiers 2

IdentifierTypeStateIssuer
268OtherLADHH
1031810MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071107000015 LA Part A Provider - Hospice 8628165719 Practice locations: Oakdale, LA

Hospice certification: CCN 191656

Legal name
HARBOR HOSPICE OF OAKDALE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 17, 2007
Last certification
May 26, 2021
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Jun 12, 2007 in LA
Enrollment address
209N 16TH St
Oakdale, LA 71463-2211

Care Compare: Hospice

Medicare Care Compare
Listed as
Harbor Hospice of Oakdale, LLCCCN 191656 · All quality measures
Ownership
For-Profit
Certified
Dec 17, 2007
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Harbor Hospice of Baton Rouge LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

144 S 10th St
Oakdale, LA 71463
Phone (337) 231-6969

209 N 16th St
Oakdale, LA 71463
Phone (318) 335-5029

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karen Carter Individual W-2 Managing Employee Feb 1, 2019
Arfeen Properties, L.P. Organization, Beaumont, TX 5% Or Greater Direct Ownership Interest Jan 1, 2010 100%
Operational/Managerial Control Jan 1, 2010 100%
Qamar U Arfeen Individual 5% Or Greater Indirect Ownership InterestManager Jan 1, 2010 50%
Corporate OfficerManager Jun 12, 2007
Operational/Managerial ControlManager Jun 12, 2007
Kelley L Arfeen Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2010 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Qamar U Arfeen, M.D.
    • Pulmonary Disease Physician
    • Beaumont, TX
    • NPI 1295738649

    5% Or Greater Indirect Ownership Interest, Corporate Officer, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 45

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 45

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1033313200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-2332",
            "fax_number": "409-232-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N 16TH ST",
            "city": "OAKDALE",
            "state": "LA",
            "postal_code": "714632211",
            "telephone_number": "318-335-5029",
            "fax_number": "318-335-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF OAKDALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "THIBODAUX",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIEF DATA OFFICER",
        "authorized_official_telephone_number": "409-813-2332",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "19-1656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHH",
            "identifier": "268",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031810",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, LA

Sources for this page

Verify at the official NPI Registry.