Favor Hospice Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

067-0443-H Issued in GA

Legal business name

FAVOR HOSPICE CARE LLC

Practice address

1400 Buford Hwy
Ste M3
Sugar Hill, GA 30518-8725

Phone

(901) 495-4456

NPI assigned

Mar 13, 2013

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adekunbi Adedipe

Title

Ceo

Phone

(901) 495-4456

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669713871. Details of each certification follow.

• CCN 111795 Hospice · Active · Details

Hospice certification: CCN 111795

Legal name

FAVOR HOSPICE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 16, 2018

Last certification

May 26, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jun 30, 2017 in GA

Enrollment address

1400 Buford Hwy
Ste M3
Buford, GA 30518-8725

Listed as

Favor Hospice CareCCN 111795 · All quality measures

Ownership

For-Profit

Certified

Apr 16, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1669713871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BUFORD HWY",
            "address_2": "SUITE M-3",
            "city": "SUGAR HILL",
            "state": "GA",
            "postal_code": "305188725",
            "telephone_number": "901-279-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BUFORD HWY",
            "address_2": "STE M3",
            "city": "SUGAR HILL",
            "state": "GA",
            "postal_code": "305188725",
            "telephone_number": "901-495-4456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Paradise Way",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Red Oak",
            "state": "TX",
            "postal_code": "751548880",
            "country_code": "US",
            "telephone_number": "901-279-6442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAVOR HOSPICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "ADEDIPE",
        "authorized_official_first_name": "ADEKUNBI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-495-4456"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "067-0443-H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Sugar Hill, GA
• Providers in Sugar Hill, 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 Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.