Provider Demographics
NPI:1538816350
Name:CREEK VIEW HOSPICE LLC
Entity type:Organization
Organization Name:CREEK VIEW HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BASILIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-576-1313
Mailing Address - Street 1:PO BOX 95584
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-5584
Mailing Address - Country:US
Mailing Address - Phone:602-603-5165
Mailing Address - Fax:602-314-6986
Practice Address - Street 1:4657 EAST COTTON GIN LOOP
Practice Address - Street 2:SUITE 102B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040
Practice Address - Country:US
Practice Address - Phone:602-603-5165
Practice Address - Fax:602-314-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based