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General NPI Number Information
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NPI Number | 1346738879
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Entity Type | Organization
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Legal Business Name | MADRONA HOSPICE AZ LLC
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 410 N SCOTTSDALE RD STE 1000
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City | TEMPE
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State | AZ
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Zip | 85281-7095
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Country | US
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Telephone | 480-566-5997
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Fax | 480-219-8283
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Provider Business Mailing Address
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Address Line | 10752 N 89TH PL STE 104A
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6731
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Country | US
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Telephone | 480-566-5997
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Fax | 480-219-8283
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL STEELE
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Credential |
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Telephone | 425-247-9786
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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 | HSPC8708
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License Number State | AZ
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