Provider Demographics
NPI:1811363302
Name:ANELIME HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:ANELIME HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAKELT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:520-484-8484
Mailing Address - Street 1:9341 E MCKELLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-2632
Mailing Address - Country:US
Mailing Address - Phone:520-484-8484
Mailing Address - Fax:
Practice Address - Street 1:660 S PINAL PKWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-9726
Practice Address - Country:US
Practice Address - Phone:520-484-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based