Haven Hospice and Palliative Care of Georgia, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HAVEN HOSPICE AND PALLIATIVE CARE OF GEORGIA, LLC

Practice address

2330 Scenic Hwy S Ste 311
Snellville, GA 30078-3115

Phone

(679) 252-2164

Fax

(770) 202-7201

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Jeri Tidwell

Title

Managing Partner

Phone

(770) 882-8174

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 851614

Legal name

HAVEN HOSPICE AND PALLIATIVE CARE OF GEORGIA LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 2, 2026

Last certification

Feb 2, 2026

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Enrollment address

2330 Scenic Hwy S
Ste 311
Snellville, GA 30078-3115

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Karla L Booker, MD

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1144359027

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1194598185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S STE 311",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "679-252-2164",
            "fax_number": "770-202-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S STE 311",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "679-252-2164",
            "fax_number": "770-202-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HOSPICE AND PALLIATIVE CARE OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "JERI",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "770-882-8174"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• London Christy Harroff, B.S., D.C.
• Sheri Miranda Hart
• Gloria A. Hatney, OTR
• Hattie'S Nursing Hands, Inc.
• Haven Developmental Care
• Roger Charlton Hawes, D.C.
• Cynthia D Hawkins, MT005449
• Calvin Hayes
• Charlotte A Hayes, MD
• Headache and Neurological Care Center PC

• Community Based Hospice Care Agency in Snellville, GA
• Providers in Snellville, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.