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General NPI Number Information
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NPI Number | 1659183358
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Entity Type | Organization
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Legal Business Name | ANGELS GRACE HOSPICE AND PALLIATIVE CARE LP
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 653 ROBERTS DR # A3
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City | RIVERDALE
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State | GA
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Zip | 30274-2959
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Country | US
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Telephone | 678-619-7643
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Fax | 678-802-4741
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Provider Business Mailing Address
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Address Line | 653 ROBERTS DR # A3
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City | RIVERDALE
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State | GA
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Zip | 30274-2959
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Country | US
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Telephone | 678-619-7643
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Fax | 678-802-4741
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Authorized Official
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Title or Position | CO OWNER
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Name | ANITA PRINCE
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Credential | FNP
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Telephone | 678-619-7643
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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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