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General NPI Number Information
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NPI Number | 1104362425
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Entity Type | Organization
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Legal Business Name | GOLDEN CARE HOSPICE OF ATLANTA, INC.
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 2140 MCGEE RD SUITE A-2400
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City | SNELLVILLE
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State | GA
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Zip | 30078-2980
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Country | US
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Telephone | 770-910-9566
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Fax | 770-910-9567
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Provider Business Mailing Address
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Address Line | 2140 MCGEE RD SUITE A2400
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City | SNELLVILLE
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State | GA
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Zip | 30078-5272
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Country | US
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Telephone | 678-956-7322
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Fax | 678-956-5076
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. COLANDREA C TUGGLE
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Credential |
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Telephone | 678-956-7322
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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 |
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License Number State |
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