Homestead Hospice of Southwest Alabama, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

E1205 Issued in AL

Legal business name

HOMESTEAD HOSPICE OF SOUTHWEST ALABAMA, LLC

Practice address

13456 Choctaw Ave
Gilbertown, AL 36908-9502

Phone

(251) 843-3151

Fax

(251) 843-3158

NPI assigned

Dec 9, 2013

Last updated

Jun 29, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

CREATIVE HOSPICE HOLDING, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Jeanne Pete

Title

VP

Phone

(770) 825-6550

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Tax ID family

Daystar Hospice Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Daystar Hospice Care LLC

  • Community Based Hospice Care Agency
  • Gilbertown, AL
  • NPI 1407035595
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Creative Hospice Care Inc

  dba Eternal Faith Hospice and Palliative Care

  • Clinic/Center
  • Bogart, GA
  • NPI 1437897956

  Member Of

  NPD member

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Homestead Hospice of Cahaba, LLC

  dba Traditions Health

  • Community Based Hospice Care Agency
  • Prattville, AL
  • NPI 1275933624

  Sold to, 2016-04-15

  CMS change of ownership

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1386075927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10888 CRABAPPLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755850",
            "telephone_number": "678-966-0077",
            "fax_number": "678-367-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13456 CHOCTAW AVE",
            "city": "GILBERTOWN",
            "state": "AL",
            "postal_code": "369089502",
            "telephone_number": "251-843-3151",
            "fax_number": "251-843-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD HOSPICE OF SOUTHWEST ALABAMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CREATIVE HOSPICE HOLDING, LLC",
        "enumeration_date": "2013-12-09",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "PETE",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "770-825-6550",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AL",
            "license": "E1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158932",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander C. Coleman, MD
• Daystar Hospice Care LLC
• First Choice Home Care
• Franklin Primary Health Center, Inc. (Gilbertown Medical Center)
• Leslie Gill, LICSW
• Hometown Pharmacy
• Howard in Home Respite Services
• Howard Personal Care Services LLC
• Jessica Koen
• Valerie Long, PHARMD

• Community Based Hospice Care Agency in Gilbertown, AL
• Providers in Gilbertown, AL by specialty
• Community Based Hospice Care Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.