Provider Demographics
NPI:1841958386
Name:LUCENDA CARE HOSPICE
Entity type:Organization
Organization Name:LUCENDA CARE HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-943-1500
Mailing Address - Street 1:4320 E FLORIAN AVE
Mailing Address - Street 2:STE E
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2685
Mailing Address - Country:US
Mailing Address - Phone:480-943-1500
Mailing Address - Fax:480-943-1600
Practice Address - Street 1:4320 E FLORIAN AVE
Practice Address - Street 2:STE E
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2685
Practice Address - Country:US
Practice Address - Phone:480-943-1500
Practice Address - Fax:480-943-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031783Medicaid