Provider Demographics
NPI:1073220158
Name:PHOENIX HEART HOSPICE LLC
Entity Type:Organization
Organization Name:PHOENIX HEART HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-352-1667
Mailing Address - Street 1:18444 N 25TH AVE STE 420-10
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1261
Mailing Address - Country:US
Mailing Address - Phone:661-644-1259
Mailing Address - Fax:
Practice Address - Street 1:18444 N 25TH AVE STE 420-10
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1261
Practice Address - Country:US
Practice Address - Phone:661-644-1259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based