Active NPI
HL Haydel Memorial Hospice
Doing business as Haydel Memorial Hospice
- Community Based Hospice Care Agency
- Houma, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- HL HAYDEL MEMORIAL HOSPICE
- Doing business as
- Haydel Memorial Hospice
- Practice address
- 102 Wilson Ave
Houma, LA 70364-3138 - Phone
- (985) 655-1020
- Fax
- (985) 655-1023
- NPI assigned
- Mar 4, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Richard Michael Haydel Jr., MHA
- Title
- Owner
- Phone
- (985) 655-1020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
102 Wilson Ave
Houma, LA 70364-3138
Mailing address
102 Wilson Ave
Houma, LA 70364-3138
Phone (985) 655-1020
Other names 1
- Haydel Memorial Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091106000338 | LA | Part A Provider - Hospice | 5092863332 | Practice locations: Houma, LA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1487894432. Details of each certification follow.
Hospice certification: CCN 191576
- Legal name
- HL HAYDEL MEMORIAL HOSPICE
- Doing business as
- HAYDEL MEMORIAL HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 22, 2003
- Last certification
- Mar 12, 2020
- Ownership / control type
- Proprietary - Partnership
- Organization structure
- LLC
- Incorporated
- in LA
- Enrollment address
- 741 Point St
Houma, LA 70360-4740
Care Compare: Hospice
Medicare Care Compare- Listed as
- Haydel Memorial Hospice
- Ownership
- For-Profit
- Certified
- May 22, 2003
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2222497 | HL Haydel Memorial Hospice | Certificate of waiver | Apr 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
1297 Saint Charles St
Ste H
Houma, LA 70360
Phone (985) 655-1020
102 Wilson Ave
Houma, LA 70364
Phone (985) 655-1020
741 Point St
Houma, LA 70360
Phone (985) 655-1020
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Shannon Huber | 5% Or Greater Direct Ownership Interest | Jul 22, 2009 | |
| David Schonberg | 5% Or Greater Direct Ownership Interest | Jul 22, 2009 | |
| Richard Haydel | 5% Or Greater Direct Ownership Interest | Jul 22, 2009 | |
| Laurie Gallagher | W-2 Managing Employee | Aug 26, 2010 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Thibodaux, LA
- NPI 1023620259
Affiliated clinicians 10
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": "1236124800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1248652800000",
"number": "1487894432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 WILSON AVE",
"city": "HOUMA",
"state": "LA",
"postal_code": "703643138",
"telephone_number": "985-655-1020",
"fax_number": "985-655-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 WILSON AVE",
"city": "HOUMA",
"state": "LA",
"postal_code": "703643138",
"telephone_number": "985-655-1020",
"fax_number": "985-655-1023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HL HAYDEL MEMORIAL HOSPICE",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-04",
"last_updated": "2009-07-27",
"status": "A",
"authorized_official_last_name": "HAYDEL",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "985-655-1020",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Haydel Memorial Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Houma, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.