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Organization

PROVIDENCE HOSPICE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IAN K. ASH (CHIEF EXECUTIVE OFFICE)
(404) 644-5134
Entity
Organization

Contact information

Practice address
100 CORPORATE CENTER DRIVE, LOWER LEVEL, STOCKBRIDGE, GA 30281-7244
(678) 284-9385
(678) 284-9391
Mailing address
100 CORPORATE CENTER DRIVE, LOWER LEVEL, STOCKBRIDGE, GA 30281-7244
(678) 284-9385
(678) 284-9391

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
075-0253-H
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015893264A
GA
Enumeration date
11/14/2006
Last updated
12/03/2010
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