Provider Demographics
NPI:1750102604
Name:PEACEFUL PURPOSE HOSPICE OF EAST GEORGIA, LLC
Entity type:Organization
Organization Name:PEACEFUL PURPOSE HOSPICE OF EAST GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-435-0085
Mailing Address - Street 1:106A N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-1020
Mailing Address - Country:US
Mailing Address - Phone:706-991-5444
Mailing Address - Fax:877-422-1281
Practice Address - Street 1:7129 FLOYD ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1578
Practice Address - Country:US
Practice Address - Phone:404-435-0085
Practice Address - Fax:877-422-1281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based