Provider Demographics
NPI:1912861725
Name:ENCORE HOSPICE LLC
Entity type:Organization
Organization Name:ENCORE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVA
Authorized Official - Middle Name:HOLLY
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-248-6636
Mailing Address - Street 1:3655 W ANTHEM WAY STE A109-386
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0430
Mailing Address - Country:US
Mailing Address - Phone:623-248-6636
Mailing Address - Fax:623-250-2371
Practice Address - Street 1:4122 W INNOVATIVE DR STE 101H&I
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-3846
Practice Address - Country:US
Practice Address - Phone:623-248-6636
Practice Address - Fax:623-250-2371
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCORE HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-15
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty