Healthcare Provider Details

I. General information

NPI: 1801296421
Provider Name (Legal Business Name): HOSPICE OF GREEN VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N LA CANADA DR
GREEN VALLEY AZ
85614-3129
US

IV. Provider business mailing address

150 N LA CANADA DR
GREEN VALLEY AZ
85614-3129
US

V. Phone/Fax

Practice location:
  • Phone: 520-230-4532
  • Fax: 520-352-3095
Mailing address:
  • Phone: 520-230-4532
  • Fax: 520-352-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KATIE BARANS
Title or Position: DIRECTOR
Credential: MSW MBA
Phone: 520-230-4532