Healthcare Provider Details

I. General information

NPI: 1194659607
Provider Name (Legal Business Name): FAMILY HOSPICE OF NORTHWEST GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 S THORNTON AVE STE B
DALTON GA
30720-8230
US

IV. Provider business mailing address

714 S THORNTON AVE STE B
DALTON GA
30720-8230
US

V. Phone/Fax

Practice location:
  • Phone: 800-410-4663
  • Fax:
Mailing address:
  • Phone: 800-410-4663
  • 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: CHARLES HALL
Title or Position: CEO
Credential:
Phone: 800-410-4663