Provider Demographics
NPI:1750793469
Name:ARIZONA FAMILY HOSPICE LLC
Entity type:Organization
Organization Name:ARIZONA FAMILY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOHATAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-991-8200
Mailing Address - Street 1:10505 N 69TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4532
Mailing Address - Country:US
Mailing Address - Phone:480-991-8200
Mailing Address - Fax:480-443-0375
Practice Address - Street 1:291 S MAIN ST
Practice Address - Street 2:SUITE G4
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1414
Practice Address - Country:US
Practice Address - Phone:928-276-4477
Practice Address - Fax:928-276-4481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA FAMILY HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC4911251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based