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PROVIDENCE HOSPICE, LLC

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Company Details

Name: PROVIDENCE HOSPICE, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 31 Oct 2003 (22 years ago)
Business ID: 741274
ZIP code: 39211
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 13 NORTHTOWN DRIVE, SUITE 220JACKSON, MS 39211

Agent

Name Role Address
Keyes, Richard E Agent 13 Northtown Drive Suite 220, Jackson, MS 39211

Member

Name Role Address
ROYCE DELANEY Member 14 NORTHTOWN DR #202, P O BOX 6015, JACKSON, MS 39211-6015
Rebecca Shelton Member 13 NORTHTOWN DRIVE, STE 220, JACKSON, MS 39211

National Provider Identifier

NPI Number:
1548218738

Authorized Person:

Name:
MR. RICHARD E KEYES
Role:
MANAGING MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
251G00000X - Community Based Hospice Care Agency
Is Primary:
Yes

Contacts:

Fax:
6019560743

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2015-12-08 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2015-09-16 Notice to Dissolve/Revoke
Annual Report LLC Filed 2014-01-29 Annual Report LLC
Annual Report LLC Filed 2013-07-18 Annual Report LLC
Notice to Dissolve/Revoke Filed 2013-07-01 Notice to Dissolve/Revoke
Annual Report LLC Filed 2012-03-08 Annual Report LLC
Annual Report LLC Filed 2011-03-14 Annual Report LLC
Amendment Form Filed 2011-02-22 Amendment
Name Reservation Form Filed 2003-10-31 Name Reservation

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Date of last update: 30 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website