Provider Demographics
NPI:1578170643
Name:ARIZONA AMERICAN HOSPICE LLC
Entity Type:Organization
Organization Name:ARIZONA AMERICAN HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SIOZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-399-2610
Mailing Address - Street 1:1325 S 123RD DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-3140
Mailing Address - Country:US
Mailing Address - Phone:602-399-2610
Mailing Address - Fax:480-718-8633
Practice Address - Street 1:1325 S 123RD DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-3140
Practice Address - Country:US
Practice Address - Phone:602-399-2610
Practice Address - Fax:480-718-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health