NPIMap

Organization Active NPI

Professional Hospice Care, L.L.C.

Doing business as Allegiance Hospice Care of Northeast Louisiana

  • Community Based Hospice Care Agency
  • Ruston, LA
National Provider Identifier
1649205261
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
156 Issued in LA
Legal business name
PROFESSIONAL HOSPICE CARE, L.L.C.
Doing business as
Allegiance Hospice Care of Northeast Louisiana
Practice address
1229 Farmerville Hwy
Ruston, LA 71270-3513
Phone
(318) 232-1107
Fax
(318) 232-1108
NPI assigned
Jul 12, 2006
Last updated
Jul 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Mr. Rock M Bordelon
Title
Owner
Phone
(318) 226-8202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 156 LA Primary

Addresses

Primary practice location

1229 Farmerville Hwy
Ruston, LA 71270-3513

Mailing address

1229 Farmerville Hwy
Ruston, LA 71270-3513
Phone (318) 232-1107

Other identifiers 1

IdentifierTypeStateIssuer
1583936MedicaidLA

Other names 2

  • Allegiance Hospice Care of Northeast Louisiana Doing business as
  • North Central Louisiana Hospice Care, L.L.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050413000353 LA Part A Provider - Hospice 5698712453 Practice locations: Ruston, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649205261. Details of each certification follow.

Hospice certification: CCN 191603

Legal name
PROFESSIONAL HOSPICE CARE, L.L.C.
Doing business as
ALLEGIANCE HOSPICE AND PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 9, 2005
Last certification
Jul 13, 2022
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Jul 8, 2004 in LA
Enrollment address
1229 Farmerville Hwy
Ruston, LA 71270-3513

Care Compare: Hospice

Medicare Care Compare
Listed as
Allegiance Hospice & Palliative CareCCN 191603 · All quality measures
Ownership
For-Profit
Certified
Mar 9, 2005
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

525 Alexander St
Jonesboro, LA 71251
Phone (318) 259-4676

118 Monticello Ave
Ste A
Ruston, LA 71270
Phone (318) 232-1107

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Rock Bordelon Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2021 95%
Corporate Officer Dec 31, 2021
Corporate Director Dec 31, 2021
Allegiance Healthcare of Louisiana, LLC Organization, Bossier City, LA LLC 5% Or Greater Indirect Ownership Interest Jan 31, 2022 95%
David Colvin Individual 5% Or Greater Indirect Ownership Interest Apr 5, 2022 5%
Brandon Melancon Individual Corporate OfficerDirector of Hospice Operations Aug 8, 2022
Operational/Managerial ControlDirector of Hospice Operations Aug 8, 2022
Joseph Monsour Individual Corporate Director Dec 31, 2021
Operational/Managerial Control Dec 31, 2021
Allegiance Hospice Care of Northeast Louisiana LLC Organization, Bossier City, LA LLC 5% Or Greater Direct Ownership Interest Dec 31, 2021 100%
Allegiance Home Health LLC Organization, Bossier City, LA LLC, For-profit Operational/Managerial Control Dec 31, 2021 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

Affiliated clinicians 2

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1649205261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 FARMERVILLE HWY",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703513",
            "telephone_number": "318-232-1107",
            "fax_number": "318-232-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 FARMERVILLE HWY",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703513",
            "telephone_number": "318-232-1107",
            "fax_number": "318-232-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOSPICE CARE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "BORDELON",
        "authorized_official_first_name": "ROCK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-226-8202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1583936",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegiance Hospice Care of Northeast Louisiana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Central Louisiana Hospice Care, L.L.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.