Provider Demographics
NPI:1952853632
Name:HOSPICE OF AMERICA LLC
Entity Type:Organization
Organization Name:HOSPICE OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YANELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-696-4980
Mailing Address - Street 1:1837 S MESA DR STE C200
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-6246
Mailing Address - Country:US
Mailing Address - Phone:480-219-8259
Mailing Address - Fax:480-686-8263
Practice Address - Street 1:1837 S MESA DR STE C200
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6246
Practice Address - Country:US
Practice Address - Phone:480-219-8259
Practice Address - Fax:480-686-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based