| NPI | 1255417432 |
|---|---|
| Doing Business As | JACKSON LAKE HOSPICE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KEITH HENSON CEO 770-305-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |