Provider Demographics
NPI:1144947227
Name:ARC HOSPICE GA, LLC
Entity type:Organization
Organization Name:ARC HOSPICE GA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-647-1536
Mailing Address - Street 1:100 CHALLENGER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-2121
Mailing Address - Country:US
Mailing Address - Phone:917-647-1536
Mailing Address - Fax:
Practice Address - Street 1:2751 BUFORD HWY NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5456
Practice Address - Country:US
Practice Address - Phone:678-383-9973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based