Countryside Hospice-Decatur

LBN: Countryside Hospice Care, Inc.
Countryside Hospice-Decatur is an health care organization with primary practice located at 801 Church Street Ne Suites 6 And 7, Decatur GA 35601-2400. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Countryside Hospice Care, Inc. can be contacted via phone (256) 432-2718, or through Berg, Michael T. via phone (505) 821-3355.

Contact Information

Primary practice address
801 Church Street Ne Suites 6 And 7 Decatur GA 35601-2400
Phone: (256) 432-2718
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berg, Michael T. J.D.
Phone: (505) 821-3355

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X 01-1579PSL Alabama

Profile Details

NPI number 1508136862
LBN Legal business name Countryside Hospice Care, Inc.
DBA Doing business as Countryside Hospice-Decatur
Authorized official Berg, Michael T. J.D.
Entity Organization
Organization subpart 1 No
Enumeration date Jan 4th, 2012
Last updated Jan 4th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508136862 NPPES
Alabama MEDICAID PIC1579EPSL

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