Provider Demographics
NPI:1346738879
Name:MADRONA HOSPICE AZ LLC
Entity Type:Organization
Organization Name:MADRONA HOSPICE AZ LLC
Other - Org Name:MADRONA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-247-9786
Mailing Address - Street 1:10752 N 89TH PL STE 104A
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6731
Mailing Address - Country:US
Mailing Address - Phone:480-566-5997
Mailing Address - Fax:480-219-8283
Practice Address - Street 1:410 N SCOTTSDALE RD STE 1000
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-7095
Practice Address - Country:US
Practice Address - Phone:480-566-5997
Practice Address - Fax:480-219-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC8708251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based