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General NPI Number Information
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NPI Number | 1063507655
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Entity Type | Organization
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Legal Business Name | SPARROW'S CREST HOSPICE
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3480 GREENBRIAR PARKWAY
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City | ATLANTA
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State | GA
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Zip | 30331
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Country | US
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Telephone | 678-314-8058
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Fax |
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Provider Business Mailing Address
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Address Line | 7033 BRECKEN TRACE
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City | LITHONIA
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State | GA
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Zip | 30058
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Country | US
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Telephone | 770-482-5708
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. VALERIE D. CAMPBELL
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Credential | RN,BSN
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Telephone | 678-314-8058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 060-0252-H
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License Number State | GA
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