HARBOR GRACE HOSPICE, INC. (NPI# 1205960473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205960473 |
| Entity Type | Organization |
| Organization Name | HARBOR GRACE HOSPICE, INC. |
| Practice Address |
500 W Lanier Ave Suite 401 Fayetteville GA 30214-7636 |
| Practice Telephone | 6789625850 |
| Practice Fax Number | 6789625855 |
| Mailing Telephone | 6789625850 |
| Mailing Fax Number | 6789625855 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2009-08-13 |
| Authorized Official Name | MS. JODI WRENN (ADMINISTRATOR) |
| Authorized Official Telephone | 6789625850 |
| Authorized Official Credential | RN, CHPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 056-242-H | GA | Agencies |
| Street Address |
500 W LANIER AVE SUITE 401 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396737680 | Torey B Clark | Specialist | 500 W Lanier Ave, Suite 406, Fayetteville, GA 30214-7636 | 2005-08-22 |
| 1306168190 | Human Services Management Group, Inc. | Community/Behavioral Health | 500 W Lanier Ave, Suite 408, Fayetteville, GA 30214-7636 | 2010-02-19 |
| 1376878223 | Ems | Nursing Care | 500 W Lanier Ave, Ste 410, Fayetteville, GA 30214-7636 | 2009-10-10 |
| 1972743946 | Edith Ezeigbo | Durable Medical Equipment & Medical Supplies | 500 W Lanier Ave, Building 200, Suite 202, Fayetteville, GA 30214-7636 | 2009-03-03 |
| 1689810475 | Atlanta South Gynecology and Obstetrics P.C. | Clinic/Center | 500 W Lanier Ave, Ste.405, Fayetteville, GA 30214-7636 | 2008-12-29 |
| 1104062355 | Elite Staffing Group for Surgical Nurses, LLC. | Nursing Care | 500 W Lanier Ave, Suite 606a, Fayetteville, GA 30214-7636 | 2008-12-17 |
| 1922288224 | Torey B. Clark, Md PC | Specialist | 500 W Lanier Ave, Suite 406, Fayetteville, GA 30214-7636 | 2007-11-05 |
| 1356533079 | Sedona Counseling, Inc | Counselor | 500 W Lanier Ave, Suite 508, Fayetteville, GA 30214-7636 | 2007-08-16 |
| 1851510051 | Deborah Brehm | Counselor | 500 W Lanier Ave, Suite 913, Fayetteville, GA 30214-7636 | 2007-04-25 |
| 1962629360 | Sutton Orthopaedics & Sports Medicine, P.C. | Durable Medical Equipment & Medical Supplies | 500 W Lanier Ave, Suite 506, Fayetteville, GA 30214-7636 | 2007-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881255875 | Bayada Home Health Care, Inc. | Hospice Care, Community Based | 2550 Ravenhill Dr Ste 202, Fayetteville, NC 28303-9628 | 2019-06-21 |
| 1528485364 | Precious Hospice, LLC | Hospice Care, Community Based | 105 Habersham Dr Ste D, Fayetteville, GA 30214-7341 | 2014-03-18 |
| 1487897674 | Doctors Hospice of Georgia, Inc | Hospice Care, Community Based | 1008 Highway 54, Fayetteville, GA 30215-0000 | 2009-04-17 |
| 1477711943 | Emma Margaret Williams | Hospice Care, Community Based | 6732 Pacific Ave, Fayetteville, NC 28314-6519 | 2008-05-30 |
| 1811198641 | Washington Regional Medical Center | Hospice Care, Community Based | 325 E Longview St, Fayetteville, AR 72703-4618 | 2007-05-30 |
| 1043344914 | Professional Care Services, Inc. | Hospice Care, Community Based | 517 Southwick Dr., Fayetteville, NC 28303 | 2007-03-15 |
| 1215088323 | On-call Nursing Inc | Hospice Care, Community Based | 2557 Ravenhill Dr, Ste D-1, Fayetteville, NC 28303-9615 | 2007-01-15 |
| 1508882937 | Hospice Advantage, LLC. | Hospice Care, Community Based | 145 Howard Ln, Fayetteville, GA 30215-1848 | 2006-07-15 |
| 1528015369 | Carrolton Home Care, LLC | Hospice Care, Community Based | 2800 Breezewood Ave, Suite 100, Fayetteville, NC 28303-5286 | 2006-05-27 |
| 1588610885 | Lincoln Medical Home Health & Hospice | Hospice Care, Community Based | 1797 Wilson Pkwy, Fayetteville, TN 37334-2770 | 2006-05-26 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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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.