Provider Demographics
NPI:1548360696
Name:LHCG XII, LLC
Entity type:Organization
Organization Name:LHCG XII, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-247-1801
Mailing Address - Street 1:1000 CHINABERRY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2443
Mailing Address - Country:US
Mailing Address - Phone:318-684-6050
Mailing Address - Fax:318-684-6051
Practice Address - Street 1:2810 AMBASSADOR CAFFERY PKWY FL 6
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-5906
Practice Address - Country:US
Practice Address - Phone:337-289-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1700665Medicaid
LA190061430ZOtherBLUE CROSS BLUE SHIELD OF
LA1700665Medicaid