# COPPER COMMUNITIES HOSPICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Copper Communities Palliative Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205185170
- **Authorized official:** RICHARD E BASS (MANAGING PARTNER)
- **Authorized official phone:** (602) 717-4751

## Contact information

- **Practice address:** 1640 S STAPLEY DR, STE. 245, MESA, AZ 85204-6664
- **Practice address phone:** (480) 383-8599
- **Mailing address:** 1640 S STAPLEY DR, STE. 245, MESA, AZ 85204-6664
- **Mailing address phone:** (480) 383-8599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 163WP0000X | Pain Management Registered Nurse | — | NULL | — |
| 163WP0000X | Pain Management Registered Nurse | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2012
- **Last updated:** 08/03/2016