SACRED JOURNEY HOSPICE LLC NPI 1912489741

NPI Information

NPI: 1912489741
Provider Name: SACRED JOURNEY HOSPICE, LLC

Doing Business As: SACRED JOURNEY HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
575 PROFESSIONAL DR STE 165
LAWRENCEVILLE, GA
ZIP 30046
Phone: (678) 583-0717
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SACRED JOURNEY HOSPICE, LLC is a hospice care community based in Lawrenceville, GA. SACRED JOURNEY HOSPICE, LLC NPI is 1912489741. The provider is registered as an organization entity type.
The provider Is Doing Business As Sacred Journey Hospice.

The provider's business location address is:

575 PROFESSIONAL DR STE 165
LAWRENCEVILLE, GA
ZIP 30046-300
Phone: (678) 583-0717

The provider's authorized official is Timothy Whobrey .
The authorized official title is Provider Enrollment and has the following contact phone number (502) 630-7249.

The CLIA number assigned to this NPI record is 11D1025831 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2018 and was last updated on 11/4/2021.

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	315D00000X	Hospice, Inpatient		060-0459-H	GEORGIA	No
2	251G00000X	Hospice Care, Community Based		060-0459-H	GEORGIA	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

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