Allegiance Hospice Care of West Central Louisiana LLC
Organization Active NPI Community Based Hospice Care Agency · Leesville, LA
NPI 1992566855 · NPPES record last updated Jan 18, 2024
Key facts
- NPI
- 1992566855
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- ALLEGIANCE HOSPICE CARE OF WEST CENTRAL LOUISIANA LLC
- Practice address
- 1020 W Fertitta Blvd
Leesville, LA 71446-4645 - Phone
- (337) 509-4980
- NPI assigned
- Jan 18, 2024
- Organization subpart
- No
Authorized official
- Name
- Joe Monsour
- Title
- Ceo
- Phone
- (318) 226-8202
Facilities with the same owner 12
Affiliated clinicians 3
-
Thomas E Dobbins, M.D.
-
Clois Darien Slaughter, M.D.
Medicare Care Compare: Hospice
- Listed as
- Allegiance Healthcare, LLC
- Certified
- Dec 5, 2024
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Hospice certification: CCN 191696
- Legal name
- ALLEGIANCE HOSPICE CARE OF WEST CENTRAL LOUISIANA LLC
- Doing business as
- ALLEGIANCE HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 5, 2024
- Last certification
- Nov 27, 2024
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 27, 2023 in LA
- Enrollment address
- 1020 W Fertitta Blvd
Leesville, LA 71446-4645
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Cindy Frazier |
Corporate Director | Feb 12, 2024 | |
| Operational/Managerial Control | Dec 27, 2023 | ||
| Rock Bordelon |
5% Or Greater Indirect Ownership Interest | Dec 27, 2023 | 100% |
| Corporate Director | Feb 12, 2024 | ||
| Allegiance Healthcare of Louisiana, LLC |
5% Or Greater Direct Ownership Interest | Dec 27, 2023 | 100% |
| Operational/Managerial Control | Dec 27, 2023 | ||
| Brandon Melancon |
Corporate Director |
Feb 12, 2024 | |
| Operational/Managerial Control | Dec 27, 2023 | ||
| Joseph Monsour |
Corporate Director |
Feb 12, 2024 | |
| Operational/Managerial Control | Dec 27, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241009001766 | LA | Part a Provider - Hospice | 5698206035 | Practice locations: Leesville, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
1020 W Fertitta Blvd
Leesville, LA 71446-4645
Mailing address
1020 W Fertitta Blvd
Leesville, LA 71446-4645
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.