Basic Information
| Provider Information | |||||||||
| NPI: | 1821046665 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REGENCY HOSPICE OF GEORGIA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 491 WILLIAMSON RD | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281179252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046642876 | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HIAWASSEE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305463472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068961251 | ||||||||
| FaxNumber: | 7068961843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 07/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | ABELL | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 7046642876 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 119-189-H | GA | Y | Agencies | Hospice Care, Community Based |
No ID Information.