MEDICARE: SUNRISE HOSPICE LHC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1659203479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE HOSPICE LHC, LLC

Provider Business Mailing Address
First Line	:	1945 MESQUITE AVE STE D
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5889
Country	:	US
Telephone Number	:	928-493-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 MESQUITE AVE STE D
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5889
Country	:	US
Telephone Number	:	928-493-4410
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID THARENOS
Credential	:
Telephone Number	:	314-952-2411

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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