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General NPI Number Information
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NPI Number | 1952686768
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Entity Type | Organization
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Legal Business Name | TAPESTRY HOSPICE OF NORTHWEST GEORGIA LLC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 189 PROFESSIONAL CT SE STE 300
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City | CALHOUN
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State | GA
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Zip | 30701-7064
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Country | US
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Telephone | 706-383-8812
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Fax | 706-383-8853
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Provider Business Mailing Address
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Address Line | 2950 CHEROKEE ST NW STE 900
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City | KENNESAW
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State | GA
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Zip | 30144-6505
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Country | US
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Telephone | 706-383-8812
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Fax | 706-383-8853
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW J. NALL
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Credential | RN
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Telephone | 706-383-8812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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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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