Provider Demographics
NPI:1437186269
Name:RCHP- SIERRA VISTA INC
Entity Type:Organization
Organization Name:RCHP- SIERRA VISTA INC
Other - Org Name:CASA DE LA PAZ HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:151 COLONIA DE SALUD
Mailing Address - Street 2:STE. B
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-8223
Mailing Address - Country:US
Mailing Address - Phone:520-417-3835
Mailing Address - Fax:520-417-3919
Practice Address - Street 1:185 S MOORMAN AVE
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2700
Practice Address - Country:US
Practice Address - Phone:520-417-3080
Practice Address - Fax:520-417-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSP-C0023251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ866419Medicaid
AZ866419Medicaid