Healthcare Provider Details

I. General information

NPI: 1235051582
Provider Name (Legal Business Name): FAMILY HAVEN HOSPICE L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10451 W PALMERAS DR STE 200
SUN CITY AZ
85373-2071
US

IV. Provider business mailing address

10451 W PALMERAS DR STE 200
SUN CITY AZ
85373-2071
US

V. Phone/Fax

Practice location:
  • Phone: 480-702-7767
  • Fax:
Mailing address:
  • Phone: 480-702-7767
  • Fax:

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: JONATHAN MARCUS CLARK
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 480-702-7767