MEDICARE: SPARROW'S CREST HOSPICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	060-0252-H	GA

General Provider Information

NPI Number	:	1063507655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARROW'S CREST HOSPICE

Provider Business Mailing Address
First Line	:	7033 BRECKEN TRACE
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30058
Country	:	US
Telephone Number	:	770-482-5708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3480 GREENBRIAR PARKWAY
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331
Country	:	US
Telephone Number	:	678-314-8058
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. VALERIE D. CAMPBELL
Credential	:	RN,BSN
Telephone Number	:	678-314-8058

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/21/2022

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Directions to “SPARROW'S CREST HOSPICE ” Practice Location

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