NPI age
14 years
Enumerated 2012-01-25
● Active Type 2 · Organization
Countryside Hospice Care, Inc
Countryside Hospice Care, Inc is 1 of 591 hospice care, community based organizations in Georgia.
Primary specialty
Hospice Care, Community Based
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Cavallo
SR. Vp - Operations
Last NPPES update
2012-02-16
Source: monthly bulk 2026-05
How this organization compares
Across 591 active hospice care, community based providers in Georgia.
NPI age
14 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-01Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
105 Corporate Plaza Dr
Lagrange, GA 302412801
Mailing address
101 Sun Ave Ne
Albuquerque, NM 871094373
Authorized official
Glen Cavallo
SR. Vp - Operations
📞 4799965900
Specialties
-
Hospice Care, Community Based PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
SolAmor Hospice LaGrange
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.