Provider Demographics
NPI:1932854718
Name:PEACE OF MIND HOSPICE CARE INC
Entity Type:Organization
Organization Name:PEACE OF MIND HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADEZHDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDRIVANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-877-9361
Mailing Address - Street 1:13231 N 35TH AVE STE A11-F
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-1233
Mailing Address - Country:US
Mailing Address - Phone:747-877-9361
Mailing Address - Fax:747-877-9362
Practice Address - Street 1:13231 N 35TH AVE STE A11-F
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-1233
Practice Address - Country:US
Practice Address - Phone:747-877-9361
Practice Address - Fax:747-877-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based