ANGEL HEART HOSPICE AND PALLIATIVE CARE MOBILE LAB NPI 1780211284

NPI Information

ANGEL HEART HOSPICE AND PALLIATIVE CARE MOBILE LAB is a hospice care community based in Atlanta, GA. ANGEL HEART HOSPICE AND PALLIATIVE CARE MOBILE LAB NPI is 1780211284. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2302 PARKLAKE DR NE # 568
ATLANTA, GA
ZIP 30345-896
Phone: (470) 381-2983

The provider's authorized official is Dwelver Nikki Webb .
The authorized official title is Ceo and has the following contact phone number (470) 381-2983.

The CLIA number assigned to this NPI record is 11D2259238 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2020 and was last updated on 3/2/2022.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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