NPI 1194035766 · live from the CMS NPI Registry
Home Health Agency Of Georgia, LLC
Hospice Care, Community Based in Marietta, GA. National Provider Identifier 1194035766, active.
NPI record
| NPI | 1194035766 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 1705 Enterprise Way Se, Suite 102, Marietta, GA 30067 |
| Practice phone | 678-218-5745 |
| Mailing address | 135 Mayfair Rd, Hattiesburg, MS 39402 |
| Enumerated | October 18, 2010 |
| Last updated | August 7, 2013 |
| Authorized official | Wilford Payne, President / Ceo |
| Other names | Camellia Home Health And Hospice |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based | 251G00000X | 033 034 10 H (GA) |
| Hospice Care, Community Based primary | 251G00000X | 033-0340-H (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.