| Organization Name: | DIVINE HOSPICE AND PALLIATIVE CARE |
| NPI Number: | 1104223106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RIKESH DESAI (ADMINISTRATOR) |
| Mailing Address: | 16165 N 83rd Ave Suite 237 Peoria |
| State: | AZ US |
| Postal Code: | 853825816 |
| Phone Number: | 6238883016 |
| Fax Number: | 6027336487 |
| NPI Enumeration Date: | 11/20/2014 |
| NPI Last Update Date: | 09/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |