Provider Demographics
NPI:1174192298
Name:HOSPICE OF SEDONA INC
Entity Type:Organization
Organization Name:HOSPICE OF SEDONA INC
Other - Org Name:1CARE HOSPICE OF ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:EDROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-463-1011
Mailing Address - Street 1:3087 E WARM SPRINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3754
Mailing Address - Country:US
Mailing Address - Phone:702-463-1011
Mailing Address - Fax:
Practice Address - Street 1:8687 E VIA DE VENTURA STE 111
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3353
Practice Address - Country:US
Practice Address - Phone:480-590-2367
Practice Address - Fax:480-590-5149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based