Provider Demographics
NPI:1922747559
Name:AARONDALE HOSPICE LLC
Entity Type:Organization
Organization Name:AARONDALE HOSPICE LLC
Other - Org Name:AARONDALE HOSPICE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-720-8123
Mailing Address - Street 1:2898 W CAPRIANA DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-2687
Mailing Address - Country:US
Mailing Address - Phone:714-720-8123
Mailing Address - Fax:
Practice Address - Street 1:2898 W CAPRIANA DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-2687
Practice Address - Country:US
Practice Address - Phone:714-720-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AARONDALE HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient