Healthcare Provider Details

I. General information

NPI: 1982353520
Provider Name (Legal Business Name): ALL HEART HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N PASADENA ST
GILBERT AZ
85233-5013
US

IV. Provider business mailing address

3517 E PIKE ST
PHOENIX AZ
85050-0061
US

V. Phone/Fax

Practice location:
  • Phone: 763-464-0717
  • Fax:
Mailing address:
  • Phone: 763-464-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA SMITH
Title or Position: CEO
Credential:
Phone: 763-464-0717