Organization Name: | REGENCY HOSPICE OF GEORGIA, LLC |
NPI Number: | 1073561130 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSICA KLEBERG (VP OF LEGAL AFFAIRS) |
Mailing Address: | 4255 Wade Green Rd Nw Ste 210 Kennesaw |
State: | GA US |
Postal Code: | 301441762 |
Phone Number: | 7703827175 |
Fax Number: | 7703824927 |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 05/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 008-191-H |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |