COUNTRYSIDE HOSPICE CARE, INC. (NPI# 1508136862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508136862 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOSPICE CARE, INC. |
| Other Organization Name | COUNTRYSIDE HOSPICE-DECATUR |
| Practice Address |
801 Church Street Ne Suites 6 and 7 Decatur GA 35601-2400 |
| Mailing Address |
18831 Von Karman Blvd. Suite 400 Irvine CA 92612-1533 |
| Practice Telephone | 2564322718 |
| Mailing Telephone | 9492557129 |
| Mailing Fax Number | 5054689250 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | MICHAEL T. BERG (CORPORATE SECRETARY) |
| Authorized Official Telephone | 5058213355 |
| Authorized Official Credential | J.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 01-1579PSL | AL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | PIC1579EPSL | 05 |
| Other Name | Type Code |
|---|---|
| Countryside Hospice-Decatur | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295005437 | Countryside Hospice Care, Inc. | Hospice Care, Community Based | 5300 Oak Tree Road, Suite B and C, Millbrook, AL 36054 | 2012-01-05 |
| Street Address |
801 CHURCH STREET NE SUITES 6 AND 7 |
| City | DECATUR |
| State | GA |
| Zip Code | 35601-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780211284 | Angel Heart Hospice and Palliative Care | Hospice Care, Community Based | 3706 Manhattan Dr, Decatur, GA 30034-6111 | 2020-03-25 |
| 1497392534 | Seva Hospice, LLC | Hospice Care, Community Based | 3845 N Druid Hills Rd Ste 307, Decatur, GA 30033-3000 | 2019-12-09 |
| 1043671738 | Loving Arms Hospice Inc. | Hospice Care, Community Based | 4919 Flat Shoals Pkwy Ste 108, Decatur, GA 30034-5257 | 2016-03-09 |
| 1992960264 | Alliance Hospice LLC | Hospice Care, Community Based | 2560 E Federal Dr, Suite 707, Decatur, IL 62526-5900 | 2008-07-25 |
| 1770772089 | Rem-kiks Hospice Services, LLC | Hospice Care, Community Based | 4292 Memorial Dr, Suite B, Decatur, GA 30032-1224 | 2007-10-23 |
| 1083651525 | Aseracare Hospice - Russellville, LLC | Hospice Care, Community Based | 432 Moulton St E, Decatur, AL 35601-3002 | 2006-06-01 |
| 1245282672 | Bamah Hospice Usa, Inc | Hospice Care, Community Based | 807 2nd Ave Se, C, Decatur, AL 35601-2542 | 2006-05-16 |
| 1235189291 | Seyah Hospice of Georgia, LLC | Hospice Care, Community Based | 506 Ladson Ct, Decatur, GA 30033-5379 | 2006-05-11 |
| 1811978893 | Hospice of The Valley, Inc. | Hospice Care, Community Based | 240 Johnston St Se, Decatur, AL 35601-2516 | 2005-11-08 |
| 1720381817 | Loving Hands Hospice LLC | Hospice Care, Community Based | 2754 N Decatur Rd, Suite 114, Decatur, GA 30033-5917 | 2010-12-10 |
| Find all providers in DECATUR | ||||
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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.