Provider Demographics
NPI:1255090130
Name:GOLDEN ROSE HOSPICE CARE INC
Entity type:Organization
Organization Name:GOLDEN ROSE HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARNEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-935-0831
Mailing Address - Street 1:931 E SOUTHERN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-5036
Mailing Address - Country:US
Mailing Address - Phone:804-687-9511
Mailing Address - Fax:480-687-8724
Practice Address - Street 1:931 E SOUTHERN AVE STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5036
Practice Address - Country:US
Practice Address - Phone:804-687-9511
Practice Address - Fax:480-687-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based