Provider Demographics
NPI:1750705190
Name:HOMESTEAD PALLIATIVE CARE, INC
Entity type:Organization
Organization Name:HOMESTEAD PALLIATIVE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAHLEGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDSHARAFAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-966-0077
Mailing Address - Street 1:10888 CRABAPPLE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5850
Mailing Address - Country:US
Mailing Address - Phone:678-966-0077
Mailing Address - Fax:678-387-3716
Practice Address - Street 1:10888 CRABAPPLE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5850
Practice Address - Country:US
Practice Address - Phone:578-966-0077
Practice Address - Fax:678-387-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management