MEDICARE: LOVING HEARTS HOSPICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1508633710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING HEARTS HOSPICE LLC

Provider Business Mailing Address
First Line	:	2398 LENORA CHURCH RD STE 108
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-6921
Country	:	US
Telephone Number	:	470-549-6063
Fax Number	:

Provider Business Practice Location Address
First Line	:	2398 LENORA CHURCH RD STE 108
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-6921
Country	:	US
Telephone Number	:	470-549-6063
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAMOND BARNES
Credential	:
Telephone Number	:	470-549-6063

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	12/07/2023

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