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General NPI Number Information
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NPI Number | 1417843236
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Entity Type | Organization
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Legal Business Name | JUMPSTART HOSPICE & PALLIATIVE CARE LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 3100 FIVE FORKS TRICKUM RD SW STE 503B
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City | LILBURN
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State | GA
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Zip | 30047-1888
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Country | US
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Telephone | 678-333-3331
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Fax | 678-802-6167
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Provider Business Mailing Address
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Address Line | 3100 FIVE FORKS TRICKUM RD SW STE 503B
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City | LILBURN
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State | GA
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Zip | 30047-1888
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Country | US
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Telephone | 678-333-3331
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Fax | 678-802-6167
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLE YAHTAL
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Credential |
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Telephone | 678-499-1102
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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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