Basic Information
| Provider Information | |||||||||
| NPI: | 1407274723 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HESTIA HOSPICE & FAMILY CARE LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BROOKDALE HOSPICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PARK PLZ | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372036527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153449551 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25 WOODS LAKE RD | ||||||||
| Address2: | STE 405 | ||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296076125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643707218 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2014 | ||||||||
| LastUpdateDate: | 04/22/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| AuthorizedOfficialLastName: | EVANS | ||||||||
| AuthorizedOfficialFirstName: | DONNIS | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER, REGULATORY PRACTICES | ||||||||
| AuthorizedOfficialTelephone: | 6152780367 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HEALTH AT HOME-BHS, LLC | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | HPC0181 | SC | Y | Agencies | Hospice Care, Community Based |
No ID Information.