Southeast Hospice Network, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOUTHEAST HOSPICE NETWORK, LLC

Practice address

4330 Highway 78 E
Suite 120-121
Jasper, AL 35501-8905

Phone

(205) 387-2300

NPI assigned

Jan 2, 2007

Organization subpart

Yes

Parent organization

SOUTHEAST HOSPICE NETWORK, LLCAs reported in NPPES

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

Authorized official

Name

Debora Wilson, RN,BSN

Title

Executive Director

Phone

(205) 706-6809

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Southeast Hospice Network LLC

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Kelley Health Hospice

  • Community Based Hospice Care Agency
  • Jasper, AL
  • NPI 1447879101

  Sold to, 2020-07-31

  CMS change of ownership

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1194882969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MCFARLAND BLVD N STE 503",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062204",
            "telephone_number": "205-366-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 HIGHWAY 78 E",
            "address_2": "SUITE 120-121",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018905",
            "telephone_number": "205-387-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HOSPICE NETWORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST HOSPICE NETWORK, LLC",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-706-6809",
        "authorized_official_credential": "RN,BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PIC1663E",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaydian Lee Smoot, LCSW
• Smothers Medical LLC
• Ebony Snead, MS
• Sound Solutions LLC
• Southeast Cancer Network, Inc
• Southeast Imaging Partners LLC
• Southern Blessings Adult and Pediatric Housecall LLC
• Southern Blessings Adult and Pediatrics LLC
• Southern Care Inc
• Southern Diagnostic Laboratories, LLC

• Community Based Hospice Care Agency in Jasper, AL
• Providers in Jasper, AL by specialty
• Community Based Hospice Care Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.