1477697571 NPI number — SOLARI HOSPICE CARE, LLC

Table of content: GRACE ANASTASIA DIXON STRTP ADMINISTRATOR (NPI 1659120871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477697571 NPI number — SOLARI HOSPICE CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOLARI HOSPICE CARE, LLC
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:
1477697571
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8712 E VIA DE COMMERCIO
Provider Second Line Business Mailing Address:
SUITE 10
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85258-3362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-634-4187
Provider Business Mailing Address Fax Number:
480-634-6039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8712 E VIA DE COMMERCIO
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258-3362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-634-4187
Provider Business Practice Location Address Fax Number:
480-634-6039
Provider Enumeration Date:
02/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STILLMAN
Authorized Official First Name:
JOE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
602-795-8760

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)