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General NPI Number Information
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NPI Number | 1225772700
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Entity Type | Organization
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Legal Business Name | HOSPICE OF YAVAPAI COUNTY, LLC
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 8430 E SPOUSE DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-6142
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Country | US
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Telephone | 928-775-5868
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Fax | 928-775-5349
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Provider Business Mailing Address
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Address Line | 8430 E SPOUSE DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-6142
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Country | US
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Telephone | 928-775-5868
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Fax | 928-775-5349
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER/OWNER
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Name | BETH ANN FUNK
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Credential | RN
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Telephone | 928-775-5868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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