Provider Demographics
NPI:1891417465
Name:FAMILY HOSPICE ATHENS LLC
Entity Type:Organization
Organization Name:FAMILY HOSPICE ATHENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-419-9200
Mailing Address - Street 1:624 S MILLEDGE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-5811
Mailing Address - Country:US
Mailing Address - Phone:706-438-1358
Mailing Address - Fax:
Practice Address - Street 1:624 S MILLEDGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-5811
Practice Address - Country:US
Practice Address - Phone:706-438-1358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based