Provider Demographics
NPI:1770992513
Name:CREATIVE HOSPICE & PALLIATIVE CARE OF ARIZONA, INC
Entity type:Organization
Organization Name:CREATIVE HOSPICE & PALLIATIVE CARE OF ARIZONA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-825-6550
Mailing Address - Street 1:14800 W MOUNTAIN VIEW BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4795
Mailing Address - Country:US
Mailing Address - Phone:480-584-3734
Mailing Address - Fax:480-584-3744
Practice Address - Street 1:14800 W MOUNTAIN VIEW BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4795
Practice Address - Country:US
Practice Address - Phone:480-584-3734
Practice Address - Fax:480-584-3744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREATIVE HOSPICE CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based