Provider Demographics
NPI:1265835961
Name:HOSPICE OF GREEN VALLEY
Entity Type:Organization
Organization Name:HOSPICE OF GREEN VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW MBA
Authorized Official - Phone:520-230-4532
Mailing Address - Street 1:150 N LA CANADA DR
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-3129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 N LA CANADA DR
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3129
Practice Address - Country:US
Practice Address - Phone:520-230-4532
Practice Address - Fax:520-352-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient