Organization Name: | SAINT JUDE HOSPICE, LLC |
NPI Number: | 1528344553 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN M HOGAN (CONTROLLER) |
Mailing Address: | 1660 S Alma School Rd Suite 223 Mesa |
State: | AZ US |
Postal Code: | 852103069 |
Phone Number: | 4808218338 |
Fax Number: | 4808972601 |
NPI Enumeration Date: | 10/21/2011 |
NPI Last Update Date: | 04/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | HSPC4820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |