SOUTHERN GRACE HOSPICE AND PALLIATIVE CARE NPI 1124448188

NPI Information

NPI: 1124448188
Provider Name: SOUTHERN GRACE HOSPICE AND PALLIATIVE CARE
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 11D2081750

Address:
80 CANDLER RD
MCDONOUGH, GA
ZIP 30253
Phone: (678) 432-8811
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SOUTHERN GRACE HOSPICE AND PALLIATIVE CARE is a hospice care community based in Mcdonough, GA. SOUTHERN GRACE HOSPICE AND PALLIATIVE CARE NPI is 1124448188. The provider is registered as an organization entity type.

The provider's business location address is:

80 CANDLER RD
MCDONOUGH, GA
ZIP 30253-455
Phone: (678) 432-8811
Fax: (678) 432-8821

The provider's authorized official is Aubrey M Kekiwi .
The authorized official title is Ceo and has the following contact phone number (678) 432-8811.

The CLIA number assigned to this NPI record is 11D2081750 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2014 and was last updated on 11/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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