Provider Demographics
NPI:1396880852
Name:ALTUS HEALTHCARE AND HOSPICE INC
Entity type:Organization
Organization Name:ALTUS HEALTHCARE AND HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-730-8405
Mailing Address - Street 1:1 DUNWOODY PARK
Mailing Address - Street 2:SUITE 128
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7404
Mailing Address - Country:US
Mailing Address - Phone:770-730-8405
Mailing Address - Fax:770-730-8408
Practice Address - Street 1:1 DUNWOODY PARK
Practice Address - Street 2:SUITE 128
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7404
Practice Address - Country:US
Practice Address - Phone:770-730-8405
Practice Address - Fax:770-730-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-232-H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA044-232-HOtherGA STATE LICENSE
GA044-232-HOtherGA STATE LICENSE