HOMESTEAD HOSPICE OF SOUTH GEORGIA, LLC (NPI# 1306350772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306350772 |
| Entity Type | Organization |
| Organization Name | HOMESTEAD HOSPICE OF SOUTH GEORGIA, LLC |
| Practice Address |
110 10th St E Ste A Tifton GA 31794-4075 |
| Mailing Address |
10888 Crabapple Rd Roswell GA 30075-5850 |
| Practice Telephone | 6789660077 |
| Practice Fax Number | 6783873716 |
| Mailing Telephone | 6789660077 |
| Mailing Fax Number | 6783873716 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Authorized Official Name | MAHLEGA ABDSHARAFAT (CEO) |
| Authorized Official Telephone | 4044563531 |
| Is Organization Subpart | Y |
| Parent Organization Name | CREATIVE HOSPICE CARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| Street Address |
110 10TH ST E STE A |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-4075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477034361 | Affinis Hospice, LLC | Hospice Care, Community Based | 2402 Tift Ave N Ste 201, Tifton, GA 31794-1885 | 2018-08-28 |
| 1902909427 | Tift Regional Health System, Inc. | Hospice Care, Community Based | 104 8th St W, Suite 1, Tifton, GA 31794-3985 | 2006-09-07 |
| 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.