Provider Demographics
NPI:1043708803
Name:AGAPE HOSPICE CARE OF CHEROKEE COUNTY, LLC
Entity Type:Organization
Organization Name:AGAPE HOSPICE CARE OF CHEROKEE COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRODDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-763-1456
Mailing Address - Street 1:5715 BROOKSTONE DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8027
Mailing Address - Country:US
Mailing Address - Phone:770-355-2066
Mailing Address - Fax:
Practice Address - Street 1:100 LONDONDERRY CT STE 120
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7353
Practice Address - Country:US
Practice Address - Phone:404-443-0678
Practice Address - Fax:678-540-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherIRS