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General NPI Number Information
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NPI Number | 1558328583
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Entity Type | Organization
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Legal Business Name | NORTHLAND HOSPICE & PALLIATIVE CARE INC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 452 N. SWITZER CANYON DR. STE. A
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4855
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Country | US
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Telephone | 928-779-1227
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Fax | 928-779-5884
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Provider Business Mailing Address
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Address Line | P.O. BOX 977
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City | FLAGSTAFF
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State | AZ
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Zip | 83002-0997
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Country | US
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Telephone | 928-779-1227
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Fax | 928-779-5884
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. PATRICIA BARTHOLOMEW
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Credential | RN MSN
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Telephone | 928-779-1227
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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 | HSPC0007
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License Number State | AZ
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