Provider Demographics
NPI:1063278539
Name:LOVING EMBRACE HOSPICE LLC
Entity type:Organization
Organization Name:LOVING EMBRACE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:RENNER
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN
Authorized Official - Phone:480-620-8852
Mailing Address - Street 1:644 E SOUTHERN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4934
Mailing Address - Country:US
Mailing Address - Phone:480-620-8852
Mailing Address - Fax:
Practice Address - Street 1:644 E SOUTHERN AVE STE 201
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4934
Practice Address - Country:US
Practice Address - Phone:480-620-8852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based