# AHAVA HOSPICE OF FLORENCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760723332
- **Authorized official:** GLENN GRAY (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (803) 794-3269

## Contact information

- **Practice address:** 2405 2ND LOOP RD, SUITE C, FLORENCE, SC 29501-1602
- **Practice address phone:** (843) 468-9700
- **Practice address fax:** (803) 791-1634
- **Mailing address:** PO BOX 1014, IRMO, SC 29063-1014
- **Mailing address phone:** (843) 468-9700
- **Mailing address fax:** (803) 791-1634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315D00000X | Inpatient Hospice | HPC 0168 | SC | Yes |

## Other

- **Enumeration date:** 03/07/2013
- **Last updated:** 03/07/2013