Provider Demographics
NPI:1659183358
Name:ANGELS GRACE HOSPICE AND PALLIATIVE CARE LP
Entity type:Organization
Organization Name:ANGELS GRACE HOSPICE AND PALLIATIVE CARE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:678-619-7643
Mailing Address - Street 1:653 ROBERTS DR # A3
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2959
Mailing Address - Country:US
Mailing Address - Phone:678-619-7643
Mailing Address - Fax:678-802-4741
Practice Address - Street 1:653 ROBERTS DR # A3
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2959
Practice Address - Country:US
Practice Address - Phone:678-619-7643
Practice Address - Fax:678-802-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based