Provider Demographics
NPI:1417843236
Name:JUMPSTART HOSPICE AND PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:JUMPSTART HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAHTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-499-1102
Mailing Address - Street 1:3100 FIVE FORKS TRICKUM RD SW STE 503B
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-1888
Mailing Address - Country:US
Mailing Address - Phone:678-333-3331
Mailing Address - Fax:678-802-6167
Practice Address - Street 1:3100 FIVE FORKS TRICKUM RD SW STE 503B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1888
Practice Address - Country:US
Practice Address - Phone:678-333-3331
Practice Address - Fax:678-802-6167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based