Provider Demographics
NPI:1255139192
Name:FIRST FRUITS LEGACY
Entity type:Organization
Organization Name:FIRST FRUITS LEGACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-260-7688
Mailing Address - Street 1:135 RIVERSIDE PKWY SW STE 2P
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-7749
Mailing Address - Country:US
Mailing Address - Phone:615-260-7688
Mailing Address - Fax:
Practice Address - Street 1:135 RIVERSIDE PKWY SW STE 2P
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-7749
Practice Address - Country:US
Practice Address - Phone:615-260-7688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No251G00000XAgenciesHospice Care, Community Based