At Home Healthcare and Hospice LLC

Organization Active NPI Community Based Hospice Care Agency · Conyers, GA

NPI 1104031863 · NPPES record last updated Apr 7, 2026

Key facts

NPI
1104031863
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
License
031-0292-H (GA)
Legal business name
AT HOME HEALTHCARE AND HOSPICE LLC
Practice address
1051 Culpepper Dr SW # 100
Conyers, GA 30094-5986
Phone
(678) 413-1360
Fax
(678) 413-1359
NPI assigned
May 14, 2007
Organization subpart
No

Authorized official

Name
Janet Combs
Title
VP Licensure
Phone
(704) 662-1761

Owners & managing parties with NPI records 22

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 195

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 195

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Gentiva CCN 111668
Ownership
For-Profit
Certified
Mar 5, 2008
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2019419At Home Healthcare and Hospice, LLC
1051 Culpepper Drive, SW, #100, Conyers, GA 30094
Certificate of waiverAug 29, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Hospice certification: CCN 111668

Legal name
AT HOME HEALTHCARE AND HOSPICE ,LLC
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 5, 2008
Last certification
May 18, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLC · Proprietary
Incorporated
Apr 16, 2007 in GA
Enrollment address
1051 Culpepper Dr SW
Ste 100
Conyers, GA 30094-5986

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
CH Services Midco Holdings Inc
Organization · Mooresville, NC
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%
Kentucky Homecare Parent Inc.
Organization · Atlanta, GA
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas
Individual
Corporate Officer
Evp, Secretary & General Counsel
Apr 27, 2021
Curo Health Services Holdings, Inc
Organization · Mooresville, NC
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%
David Robinson Arnold
Individual
Corporate Officer
VP, Treasurer & Controller
Dec 31, 2021
Operational/Managerial Control
Chain Home Office Administrator
Dec 31, 2021
Thomas Joseph Dolan
Individual
Corporate Officer
Chief Financial Officer
Nov 30, 2021
Charlotte Midco, LLC
Organization · Atlanta, GA
LLC, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
New Century Hospice Inc
Organization · Mooresville, NC
Corporation, For-profit
5% Or Greater Direct Ownership Interest Jan 19, 2016 100%
Kentucky Homecare Holdings, Inc.
Organization · Atlanta, GA
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Humana Inc
Organization · Louisville, KY
Corporation, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP
Organization · Atlanta, GA
Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby
Individual
Corporate Officer
President & Ceo
Apr 27, 2021
Dianne Kelly
Individual
W-2 Managing Employee
Administrator
Sep 12, 2021
Charlotte Buyer, Inc.
Organization · Mooresville, NC
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Jul 11, 2018 100%
Curo Health Services LLC
Organization · Mooresville, NC
LLC, For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%
Janet L Combs
Individual
Corporate Officer
Vice President of Licensure
Nov 1, 2021
CD&R Falcon Holdings, LP
Organization · New York, NY
Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Centerwell Health Services Inc
Organization · Atlanta, GA
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc
Organization · Atlanta, GA
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Hospice Development Company 2, LLC
Organization · Mooresville, NC
For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%
CH Services Group Holdings Inc
Organization · Mooresville, NC
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%
CH Services Holdings Inc
Organization · Mooresville, NC
Corporation, Holding company, For-profit
5% Or Greater Indirect Ownership Interest Jan 19, 2016 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080117000164 GA Part a Provider - Hospice 8123109048 Practice locations: Conyers, GA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 031-0292-H GA Yes

Addresses

Primary practice location

1051 Culpepper Dr SW # 100
Conyers, GA 30094-5986

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 664-2876

Other identifiers

IdentifierTypeStateIssuer
972200610AMedicaidGA

Other names

  • Gentiva Doing business as

Other providers in Conyers, GA

All providers in Conyers, GA · Community Based Hospice Care Agency in Georgia

Sources for this page

Verify at the official NPI Registry.