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General NPI Number Information
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NPI Number | 1710607965
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Entity Type | Organization
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Legal Business Name | HOSPICE OF COCONINO COUNTY, LLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 15 N SAN FRANCISCO ST STE 206
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-5229
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Country | US
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Telephone | 602-622-1848
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Fax | 928-440-1128
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Provider Business Mailing Address
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Address Line | 5676 E CHENEY DR
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-3076
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Country | US
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Telephone | 602-622-1848
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Fax | 928-440-1128
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Authorized Official
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Title or Position | CEO
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Name | CYNTHIA DIANE LAMB
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Credential |
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Telephone | 602-622-1848
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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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