Provider Demographics
NPI:1770917692
Name:HOSPICE PROMISE LLC
Entity type:Organization
Organization Name:HOSPICE PROMISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNING
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:623-792-0070
Mailing Address - Street 1:17235 N 75TH AVE STE E175
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-0870
Mailing Address - Country:US
Mailing Address - Phone:623-209-7003
Mailing Address - Fax:623-209-7008
Practice Address - Street 1:17235 N 75TH AVE STE E175
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0870
Practice Address - Country:US
Practice Address - Phone:623-209-7003
Practice Address - Fax:623-209-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ000029Medicaid