Healthcare Provider Details

I. General information

NPI: 1770176349
Provider Name (Legal Business Name): FREE SPIRIT HOSPICE INC DBA ST PAUL HOSPICE CARE AZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2152 S VINEYARD STE 114A
MESA AZ
85210-6881
US

IV. Provider business mailing address

2152 S VINEYARD STE 114A
MESA AZ
85210-6881
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5990
  • Fax: 602-277-5619
Mailing address:
  • Phone: 602-277-5990
  • Fax: 602-277-5619

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: ISAAC HAYES CRISTOBAL
Title or Position: CEO
Credential:
Phone: 602-277-5990