Lakes Area Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

002784 Issued in TX

Legal business name

LAKES AREA HOSPICE, INC.

Practice address

254 Ethel St
Jasper, TX 75951-3614

Phone

(409) 384-5995

Fax

(409) 384-9655

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Rae M Tidwell

Title

Cfo

Phone

(409) 381-1187

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356448260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 ETHEL ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759513614",
            "telephone_number": "409-384-5995",
            "fax_number": "409-384-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 ETHEL ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759513614",
            "telephone_number": "409-384-5995",
            "fax_number": "409-384-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES AREA HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "RAE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "409-381-1187",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "002784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "HH6800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Health Services Pas-Hemphill
• Jodi Lee Kahla
• Marquita Arnell King, RN
• Robert Wayne King, D.MIN LPC LCDC RSOTP
• Eric R Koch, DDS
• Lakewood Hospital LLC
• Burton Neal Lakey, WHC NP
• Bric Lee Langford, D.C.
• Summer Lee Langford, D.C.
• Windolyn Shadae Leach

• Community Based Hospice Care Agency in Jasper, TX
• Providers in Jasper, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.