COUNTRYSIDE HOSPICE CARE, INC (NPI# 1013248814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013248814 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOSPICE CARE, INC |
| Other Organization Name | SOLAMOR HOSPICE CANTON |
| Practice Address |
203 Oakside Ln Building 203, Suite B Canton GA 30114-6407 |
| Mailing Address |
203 Oakside Ln Building 203-b Canton GA 30114-6407 |
| Practice Telephone | 7707049982 |
| Practice Fax Number | 7707042755 |
| Mailing Telephone | 7707049982 |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | MR. GLEN CAVALLO (SR. VP - OPERATIONS) |
| Authorized Official Telephone | 4799965900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 028-0350-H | GA | Agencies |
| Other Name | Type Code |
|---|---|
| SolAmor Hospice Canton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093086811 | Countryside Hospice Care, Inc | Hospice Care, Community Based | 105 Corporate Plaza Dr, Lagrange, GA 30241-2801 | 2012-01-25 |
| 1245562107 | Countryside Hospice Care, Inc | Hospice Care, Community Based | 189 Professional Ct Se, Suite 300, Calhoun, GA 30701-7053 | 2010-02-03 |
| 1518238286 | Countryside Hospice Care, Inc | Hospice Care, Community Based | 101 Sun Ave Ne, Albuquerque, NM 87109-4373 | 2012-01-26 |
| 1487950234 | Countryside Hospice Care, Inc | Hospice Care, Community Based | 245 Country Club Dr, Bldg. 300a, Stockbridge, GA 30281-9080 | 2011-01-26 |
| Street Address |
203 OAKSIDE LN BUILDING 203, SUITE B |
| City | CANTON |
| State | GA |
| Zip Code | 30114-6407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407006802 | Comprehensive Neurology of North Georgia, PC | Psychiatry & Neurology | 203 Oakside Ln, Suite A, Canton, GA 30114-6407 | 2008-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740418 | Dynamic Hospice of North Georgia, Inc. | Hospice Care, Community Based | 1558 Marietta Hwy Ste 210, Canton, GA 30114-3615 | 2020-04-28 |
| 1336506443 | Mercy Medical Center Home Health & Hospice LLC | Hospice Care, Community Based | 4369 Whipple Ave Nw, Canton, OH 44718-2643 | 2016-01-20 |
| 1093007585 | Mariam Hospice LLC | Hospice Care, Community Based | 42000 Koppernick Rd., Ste.-a-7, Canton, MI 48187-4282 | 2011-05-03 |
| 1730375049 | Transitions Hospice Care of Georgia, Inc | Hospice Care, Community Based | 1300 Oakside Drive, Suite 3, Canton, GA 30114-2473 | 2007-09-20 |
| 1144326711 | Guardian Angel Hospice Care for Children | Hospice Care, Community Based | 514 W Fulton St, Canton, MS 39046-4254 | 2006-09-14 |
| 1134139785 | Graham Hospital Association | Hospice Care, Community Based | 225 W Walnut St, Canton, IL 61520-2443 | 2006-08-08 |
| 1316900962 | Mid Delta Hospice of Canton, Inc. | Hospice Care, Community Based | 1150 E Peace St, Canton, MS 39046-4900 | 2006-04-06 |
| 1861659419 | Compassionate Care Hospice of Michigan, LLC | Hospice Care, Community Based | 5730 N Lilley Rd, Stes A&b, Canton, MI 48187-3685 | 2008-05-21 |
| 1700972601 | Aultman Hospital | Hospice Care, Community Based | 2821 Woodlawn Ave Nw, Canton, OH 44708-1423 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153492 | Legacy Hospice Ga | Hospice Care, Community Based | 1700 Frederica Rd Ste 205, St Simons Island, GA 31522-2583 | 2020-10-28 |
| 1013515030 | Perimeter Hospice of Georgia | Hospice Care, Community Based | 150 Stanley Ct Ste E, Lawrenceville, GA 30046-5215 | 2020-10-12 |
| 1780291039 | Goldencare Hospice and Palliative Care | Hospice Care, Community Based | 7555 Bridgegate Ct, Sandy Springs, GA 30350-4604 | 2020-09-29 |
| 1255947651 | Community Hospice of Georgia | Hospice Care, Community Based | 321 N Main St Ste A, Adairsville, GA 30103-2403 | 2020-09-21 |
| 1437762382 | Allaway Angels | Hospice Care, Community Based | 805 Deerfield Ct, Stone Mountain, GA 30087-5483 | 2020-08-28 |
| 1144832494 | Circle of Hope Hospice | Hospice Care, Community Based | 5750 Brook Hollow Pkwy Ste 105, Norcross, GA 30071-3515 | 2020-08-18 |
| 1518578335 | Jaslinks Hospice Inc | Hospice Care, Community Based | 2282 Meadow Church Rd Ste 300, Duluth, GA 30097-5318 | 2020-08-14 |
| 1104434570 | An Angels Touch Hospice LLC | Hospice Care, Community Based | 2345 4th St Ste 600d, Tucker, GA 30084-8518 | 2020-07-21 |
| 1609494327 | Divine Guardian LLC | Hospice Care, Community Based | 2321 4th St Ste 210, Tucker, GA 30084-8516 | 2020-07-09 |
| 1184242026 | Champions Nursing Services, LLC | Hospice Care, Community Based | 2365 Wall St Se Ste 210, Conyers, GA 30013-2197 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.