Healthcare Provider Details

I. General information

NPI: 1336163815
Provider Name (Legal Business Name): EMBRACING HOSPICECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 PEACHTREE DUNWOODY RD NE STE D 580
ATLANTA GA
30342-1556
US

IV. Provider business mailing address

50 N LAURA ST STE 1800
JACKSONVILLE FL
32202-3664
US

V. Phone/Fax

Practice location:
  • Phone: 404-659-0110
  • Fax: 770-454-7730
Mailing address:
  • Phone: 904-493-6745
  • Fax: 904-262-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number044162H
License Number StateGA

VIII. Authorized Official

Name: MR. RICH FOGLE
Title or Position: CFO
Credential:
Phone: 904-493-6745