MEDICARE: ACCEPTANCE HOSPICE AND PALLIATIVE CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	251G00000X	AZ

General Provider Information

NPI Number	:	1477810414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCEPTANCE HOSPICE AND PALLIATIVE CARE INC

Provider Business Mailing Address
First Line	:	250 N LITCHFIELD RD STE 202
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-1378
Country	:	US
Telephone Number	:	623-687-5547
Fax Number	:	480-383-6139

Provider Business Practice Location Address
First Line	:	250 N LITCHFIELD RD STE 202
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-1378
Country	:	US
Telephone Number	:	623-687-5547
Fax Number	:	480-383-6139

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ZOSIMA ABIVA VICTUELLES
Credential	:	RN
Telephone Number	:	630-890-7530

Provider Enumeration Date	:	04/16/2012
Last Update Date	:	04/16/2012

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