Healthcare Provider Details

I. General information

NPI: 1659203479
Provider Name (Legal Business Name): SUNRISE HOSPICE LHC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 MESQUITE AVE STE D
LAKE HAVASU CITY AZ
86403-5889
US

IV. Provider business mailing address

1945 MESQUITE AVE STE D
LAKE HAVASU CITY AZ
86403-5889
US

V. Phone/Fax

Practice location:
  • Phone: 928-493-4410
  • Fax:
Mailing address:
  • Phone: 928-493-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID THARENOS
Title or Position: OWNER
Credential:
Phone: 314-952-2411