Provider Demographics
NPI:1194366989
Name:LADAHMA HOSPICE LLC
Entity Type:Organization
Organization Name:LADAHMA HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MERDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMBERBATCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:470-552-8502
Mailing Address - Street 1:1755 THE EXCHANGE SE STE 360D
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 THE EXCHANGE SE STE 360D
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-7404
Practice Address - Country:US
Practice Address - Phone:617-435-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based