Organization
HOSPICE OF THE SOUTHWEST - WEST VALLEY, LLC
Active
Other names
Aviant Hospice Gila
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD E BASS (PRESIDENT)
(602) 717-4751
Entity
Organization
Contact information
Practice address
136 S BROAD ST, GLOBE, AZ 85501-2602
(928) 425-5400
(928) 425-5411
Mailing address
1640 S. STAPLEY DR., STE. 245, MESA, AZ 85204-6667
(480) 383-8599
(480) 398-1620
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
HSPC6544
AZ
251G00000X
Community Based Hospice Care Agency
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429014
—
AZ
Enumeration date
05/09/2008
Last updated
01/05/2017
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