Healthcare Provider Details

I. General information

NPI: 1326823923
Provider Name (Legal Business Name): SEASONS CARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 WALL ST SE STE 100
CONYERS GA
30013-6342
US

IV. Provider business mailing address

2425 WALL ST SE STE 100
CONYERS GA
30013-6342
US

V. Phone/Fax

Practice location:
  • Phone: 470-443-0020
  • Fax:
Mailing address:
  • Phone: 470-443-0020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMBER CAUDELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 678-800-5903