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General NPI Number Information
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NPI Number | 1871064071
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Entity Type | Organization
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Legal Business Name | SPG HOSPICE LLC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 7975 N HAYDEN RD STE B200
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3244
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Country | US
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Telephone | 480-268-2668
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Fax | 480-268-2669
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Provider Business Mailing Address
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Address Line | 7975 N HAYDEN RD STE B200
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3244
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Country | US
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Telephone | 480-268-2668
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Fax | 480-268-2669
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIMA GHADIMI
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Credential |
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Telephone | 480-268-2668
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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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