Provider Demographics
NPI:1689808156
Name:HOSPICE OF SCOTTSDALE
Entity Type:Organization
Organization Name:HOSPICE OF SCOTTSDALE
Other - Org Name:LEGACY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:TOBIAS
Authorized Official - Last Name:ASBURY
Authorized Official - Suffix:
Authorized Official - Credentials:BS & MBA
Authorized Official - Phone:480-423-3400
Mailing Address - Street 1:4237 N CRAFTSMAN CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3201
Mailing Address - Country:US
Mailing Address - Phone:480-723-3400
Mailing Address - Fax:480-423-6852
Practice Address - Street 1:4237 N CRAFTSMAN CT
Practice Address - Street 2:SUITE 201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3201
Practice Address - Country:US
Practice Address - Phone:480-723-3400
Practice Address - Fax:480-423-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC4610251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based