- Enrollment id
- O20150903000530
- Enrollment state
- GA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1528455169
- Multiple npi flag
- N
- Ccn
- 111770
- Associate id
- 2769798883
- Organization name
- HOPE HOSPICE OF ATLANTA, INC
- Incorporation date
- 2014-07-22
- Incorporation state
- GA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5604 WENDY BAGWELL PKWY
- Address line 2
- STE 422
- City
- HIRAM
- State
- GA
- Zip code
- 301417815