Provider Demographics
NPI:1629848882
Name:BRIGHTON HOSPICE GEORGIA, LLC
Entity type:Organization
Organization Name:BRIGHTON HOSPICE GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-849-0486
Mailing Address - Street 1:9800 S MONROE ST STE 808
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4419
Mailing Address - Country:US
Mailing Address - Phone:801-849-0486
Mailing Address - Fax:801-849-0476
Practice Address - Street 1:2970 CLAIRMONT RD NE STE 500
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-4417
Practice Address - Country:US
Practice Address - Phone:470-737-9490
Practice Address - Fax:470-737-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based