Provider Demographics
NPI:1124751409
Name:AT PEACE HOSPICE LLC
Entity type:Organization
Organization Name:AT PEACE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMON
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-440-2949
Mailing Address - Street 1:921 E CURRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-1905
Mailing Address - Country:US
Mailing Address - Phone:480-440-2949
Mailing Address - Fax:
Practice Address - Street 1:921 E CURRY RD STE B
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-1905
Practice Address - Country:US
Practice Address - Phone:480-440-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based