MEDICARE: FREE SPIRIT HOSPICE 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

General Provider Information

NPI Number	:	1770176349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREE SPIRIT HOSPICE INC

Provider Business Mailing Address
First Line	:	2152 S VINEYARD STE 114A
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-6881
Country	:	US
Telephone Number	:	602-277-5990
Fax Number	:	602-277-5619

Provider Business Practice Location Address
First Line	:	2152 S VINEYARD STE 114A
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-6881
Country	:	US
Telephone Number	:	602-277-5990
Fax Number	:	602-277-5619

Authorized Official
Title or Position	:	CEO
Name	:	ISAAC HAYES CRISTOBAL
Credential	:
Telephone Number	:	602-277-5990

Provider Enumeration Date	:	02/15/2021
Last Update Date	:	03/06/2026

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