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General NPI Number Information
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NPI Number | 1427206960
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Entity Type | Organization
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Legal Business Name | LONGLEAF HOSPICE, LLC
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 12/01/2024
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Provider Practice Location Address
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Address Line | 2310 PARKLAKE DR NE STE 325
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City | ATLANTA
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State | GA
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Zip | 30345-2915
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Country | US
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Telephone | 770-939-9179
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Fax | 770-621-3083
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Provider Business Mailing Address
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Address Line | 2310 PARKLAKE DR NE STE 325
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City | ATLANTA
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State | GA
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Zip | 30345-2915
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Country | US
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Telephone | 770-939-9179
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Fax | 770-621-3083
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD PHILLIP STONE
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Credential |
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Telephone | 770-939-9179
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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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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0440301H
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License Number State | GA
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