Provider Demographics
NPI:1144995929
Name:ARIZONA HOSPICE CARE INC
Entity type:Organization
Organization Name:ARIZONA HOSPICE CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-497-0302
Mailing Address - Street 1:3101 N CENTRAL AVE STE 168
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3609
Mailing Address - Country:US
Mailing Address - Phone:480-428-0262
Mailing Address - Fax:480-428-0263
Practice Address - Street 1:3101 N CENTRAL AVE STE 168
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3609
Practice Address - Country:US
Practice Address - Phone:480-428-0262
Practice Address - Fax:480-428-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based