Provider Demographics
NPI:1104362425
Name:GOLDEN CARE HOSPICE OF ATLANTA, INC.
Entity Type:Organization
Organization Name:GOLDEN CARE HOSPICE OF ATLANTA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COLANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUGGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-956-7322
Mailing Address - Street 1:2140 MCGEE RD
Mailing Address - Street 2:SUITE A2400
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5272
Mailing Address - Country:US
Mailing Address - Phone:678-956-7322
Mailing Address - Fax:678-956-5076
Practice Address - Street 1:2140 MCGEE RD
Practice Address - Street 2:SUITE A-2400
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2980
Practice Address - Country:US
Practice Address - Phone:770-910-9566
Practice Address - Fax:770-910-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based