Organization
CENTRA MANAGEMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY SMITH (OWNER)
(480) 320-4733
Entity
Organization
Contact information
Practice address
4530 E SHEA BLVD STE 142, PHOENIX, AZ 85028-6067
(480) 320-4733
(888) 920-7164
Mailing address
4530 E SHEA BLVD STE 142, PHOENIX, AZ 85028-6067
(480) 320-4733
(888) 920-7164
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L21405248
HOSPICE
AZ
Enumeration date
09/15/2020
Last updated
04/12/2022
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