Organization
JACKSON LAKE HOSPICE INC
Active
Other names
Jackson Lake Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KEITH HENSON (CEO)
(770) 305-9393
Entity
Organization
Contact information
Practice address
128 BRANDON WAY, MACON, GA 31210
(770) 305-9393
(770) 305-9662
Mailing address
PO BOX 1927, JACKSON, GA 30233-0037
(770) 305-9393
(770) 305-9662
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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