Provider Demographics
NPI:1043804230
Name:EMPEROR HOSPICE OF ARIZONA, INC.
Entity type:Organization
Organization Name:EMPEROR HOSPICE OF ARIZONA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-609-2555
Mailing Address - Street 1:14631 N CAVE CREEK RD STE 104B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4100
Mailing Address - Country:US
Mailing Address - Phone:602-609-2555
Mailing Address - Fax:602-609-2559
Practice Address - Street 1:14631 N CAVE CREEK RD STE 104B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4100
Practice Address - Country:US
Practice Address - Phone:602-609-2555
Practice Address - Fax:602-609-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-27
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based