JACKSON LAKE HOSPICE INC NPI 1255417432

NPI Information

NPI: 1255417432
Provider Name: JACKSON LAKE HOSPICE INC

Doing Business As: JACKSON LAKE HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
128 BRANDON WAY
MACON, GA
ZIP 31210
Phone: (770) 305-9393
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JACKSON LAKE HOSPICE INC is a hospice care community based in Macon, GA. JACKSON LAKE HOSPICE INC NPI is 1255417432. The provider is registered as an organization entity type.
The provider Is Doing Business As Jackson Lake Hospice.

The provider's business location address is:

128 BRANDON WAY
MACON, GA
ZIP 31210
Phone: (770) 305-9393
Fax: (770) 305-9662

The provider's authorized official is Michael Keith Henson .
The authorized official title is Ceo and has the following contact phone number (770) 305-9393.

The enumeration date for this NPI number is 10/31/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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