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General NPI Number Information
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NPI Number | 1639130065
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Entity Type | Organization
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Legal Business Name | HILLCREST HOSPICE, INC.
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1335 LAKE RIDGE PKWY
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City | RIVERDALE
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State | GA
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Zip | 30296-3393
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Country | US
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Telephone | 770-994-6569
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Fax | 770-994-3757
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Provider Business Mailing Address
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Address Line | 1800 PHOENIX BLVD SUITE 128
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City | ATLANTA
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State | GA
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Zip | 30349-5593
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Country | US
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Telephone | 678-284-5850
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Fax | 770-909-3406
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANITA HOSSFELD
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Credential | LMSW
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Telephone | 678-284-5856
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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 | 031131H
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License Number State | GA
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