Provider Demographics
NPI:1184299042
Name:AZI HOSPICE, INC.
Entity type:Organization
Organization Name:AZI HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-231-6000
Mailing Address - Street 1:7200 VINELAND AVE UNIT 220
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-5088
Mailing Address - Country:US
Mailing Address - Phone:480-231-6000
Mailing Address - Fax:818-688-0507
Practice Address - Street 1:7200 VINELAND AVE UNIT 220
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-5088
Practice Address - Country:US
Practice Address - Phone:480-231-6000
Practice Address - Fax:818-688-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based