NPIMap

Organization Active NPI

At Home Healthcare and Hospice LLC

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Conyers, GA
National Provider Identifier
1104031863
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
031-0292-H Issued in GA
Legal business name
AT HOME HEALTHCARE AND HOSPICE LLC
Doing business as
Gentiva
Practice address
1051 Culpepper Dr SW # 100
Conyers, GA 30094-5986
Phone
(678) 413-1360
Fax
(678) 413-1359
NPI assigned
May 14, 2007
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

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

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 1

IdentifierTypeStateIssuer
972200610AMedicaidGA

Other names 1

  • Gentiva Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104031863. Details of each certification follow.

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
LLCProprietary
Incorporated
Apr 16, 2007 in GA
Enrollment address
1051 Culpepper Dr SW
Ste 100
Conyers, GA 30094-5986

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 111668 · All quality measures
Ownership
For-Profit
Certified
Mar 5, 2008
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2019419At Home Healthcare and Hospice, LLC1051 Culpepper Drive, SW, #100, Conyers, GA 30094Certificate of waiverAug 29, 2026

Ownership & related parties

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 OfficerEvp, 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 OfficerVP, Treasurer & Controller Dec 31, 2021
Operational/Managerial ControlChain Home Office Administrator Dec 31, 2021
Thomas Joseph Dolan Individual Corporate OfficerChief 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 OfficerPresident & Ceo Apr 27, 2021
Dianne Kelly Individual W-2 Managing EmployeeAdministrator 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 OfficerVice 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%

Owners & managing parties with NPI records 22

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

View all 22

Facilities with the same owner 195

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

View all 195

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1104031863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 CULPEPPER DR SW # 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945986",
            "telephone_number": "678-413-1360",
            "fax_number": "678-413-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME HEALTHCARE AND HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2026-04-07",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP LICENSURE",
        "authorized_official_telephone_number": "704-662-1761"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "031-0292-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "972200610A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.