Provider Demographics
NPI:1255043816
Name:ENCORE HOSPICE LLC
Entity type:Organization
Organization Name:ENCORE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKER CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:623-695-0813
Mailing Address - Street 1:3655 W ANTHEM WAY STE. A109-386
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-695-0813
Mailing Address - Fax:
Practice Address - Street 1:4122 W INNOVATION DR
Practice Address - Street 2:STE H AND I
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086
Practice Address - Country:US
Practice Address - Phone:623-695-0813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based