Metanoia Hospice and Palliative Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

METANOIA HOSPICE AND PALLIATIVE CARE LLC

Practice address

1244 Beaver Ruin Rd Ste 205
Norcross, GA 30093-3266

Phone

(678) 528-0577

Fax

(678) 904-6845

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Tiffany Kadzako

Title

Owner

Phone

(678) 528-0577

Specialties & licenses 1

Addresses

Other names 1

• METANOIA HOSPICE Doing business as

Locations

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1124861414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 BEAVER RUIN RD STE 205",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933266",
            "telephone_number": "678-887-3388",
            "fax_number": "678-904-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 BEAVER RUIN RD STE 205",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933266",
            "telephone_number": "678-528-0577",
            "fax_number": "678-904-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METANOIA HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "KADZAKO",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-528-0577"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METANOIA HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "METANOIA HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Norcross, GA
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.