Provider Demographics
NPI:1699709857
Name:NEW HOPE HOSPICE OF ARIZONA, INC.
Entity type:Organization
Organization Name:NEW HOPE HOSPICE OF ARIZONA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMBERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SEELE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:314-815-3500
Mailing Address - Street 1:2191 LEMAY FERRY RD
Mailing Address - Street 2:STE 300
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125
Mailing Address - Country:US
Mailing Address - Phone:314-815-3500
Mailing Address - Fax:314-815-3207
Practice Address - Street 1:500 N. LAKE HAVASU AVENUE
Practice Address - Street 2:UNIT B106
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403
Practice Address - Country:US
Practice Address - Phone:928-854-4200
Practice Address - Fax:928-854-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WH1000X
AZHSPC4800251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty