National Provider Identifier Database

CROSSROADS HOSPICE OF ATLANTA LLC
Hospice Care, Community Based


Contact Information

CROSSROADS HOSPICE OF ATLANTA LLC
1957 LAKESIDE PKWY STE 500
TUCKER, GA30084-5859
Phone: 770-270-9898
Fax: 770-270-9896
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X
Hospice and Palliative Medicine 207QH0002X

* Indicates primary specialty

NPI Profile & details for CROSSROADS HOSPICE OF ATLANTA LLC

NPI Number 1699715045
Legal business name
LBN
CROSSROADS HOSPICE OF ATLANTA LLC
Authorized official CLAYTON FARMER - (CFO/COO)
Entity Organization
Organization subpart Yes
Enumeration date 06/07/2006
Last updated 11/14/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 0200515330
  • GA Medicaid: 050414737A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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