Organization Name: | PEACHTREE HOSPICE OF GEORGIA, LLC |
NPI Number: | 1043632334 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY W RASMUSSEN (PRESIDENT) |
Mailing Address: | 354 Corporate Center Ct Stockbridge |
State: | GA US |
Postal Code: | 302816360 |
Phone Number: | 6785832269 |
Fax Number: | 6785832270 |
NPI Enumeration Date: | 01/06/2014 |
NPI Last Update Date: | 02/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |