Healthcare Provider Details

I. General information

NPI: 1811736499
Provider Name (Legal Business Name): CARESOUTH HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8219 N CROSSING CT STE B
FORTSON GA
31808-6955
US

IV. Provider business mailing address

6688 N CENTRAL EXPY STE 1300
DALLAS TX
75206-3950
US

V. Phone/Fax

Practice location:
  • Phone: 762-261-3890
  • Fax: 762-210-3193
Mailing address:
  • Phone: 214-239-6500
  • Fax: 214-239-6581

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: JULIE DIANE JOLLEY
Title or Position: EVP OF HOME HEALTH OPERATIONS
Credential:
Phone: 214-239-6500