1881215945 NPI number — VALLEY CARE HOSPICE INC

Table of content: (NPI 1881215945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881215945 NPI number — VALLEY CARE HOSPICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY CARE HOSPICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881215945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2577 W QUEEN CREEK RD STE 200B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85248-0913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-359-3998
Provider Business Mailing Address Fax Number:
803-856-7854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2577 W QUEEN CREEK RD STE 200B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85248-0913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-359-3998
Provider Business Practice Location Address Fax Number:
803-856-7854
Provider Enumeration Date:
04/29/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHANNON
Authorized Official First Name:
MAI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-359-3998

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)