Provider Demographics
NPI:1487388419
Name:ATL HOSPICE AND PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:ATL HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-353-8528
Mailing Address - Street 1:2450 ATLANTA HWY STE 1202
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1253
Mailing Address - Country:US
Mailing Address - Phone:470-592-0440
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY STE 1202
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1253
Practice Address - Country:US
Practice Address - Phone:470-592-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based