Provider Demographics
NPI:1285979872
Name:LORNA HOSPICE
Entity type:Organization
Organization Name:LORNA HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANDRE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-681-5413
Mailing Address - Street 1:50 HURT PLZ SE
Mailing Address - Street 2:SUITE 845
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2946
Mailing Address - Country:US
Mailing Address - Phone:404-681-5413
Mailing Address - Fax:866-213-4854
Practice Address - Street 1:50 HURT PLZ SE
Practice Address - Street 2:SUITE 845
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2946
Practice Address - Country:US
Practice Address - Phone:404-681-5413
Practice Address - Fax:866-213-4854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0600376H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based