Healthcare Provider Details

I. General information

NPI: 1639935703
Provider Name (Legal Business Name): SOLACE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 PEACHTREE ST NE # 213
ATLANTA GA
30309-3203
US

IV. Provider business mailing address

1652 ABNER TER NW
ATLANTA GA
30318-3435
US

V. Phone/Fax

Practice location:
  • Phone: 678-913-9814
  • Fax:
Mailing address:
  • Phone: 678-913-9814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA VENSON
Title or Position: CHIEF MEDIA ORGANIZER
Credential:
Phone: 678-913-9814