Hospice of the Southwest - West Valley, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

HSPC6544 Issued in AZ

Legal business name

HOSPICE OF THE SOUTHWEST - WEST VALLEY, LLC

Doing business as

Aviant Hospice Gila

Practice address

136 S Broad St
Globe, AZ 85501-2602

Phone

(928) 425-5400

Fax

(928) 425-5411

NPI assigned

May 9, 2008

Last updated

Jan 5, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard E Bass

Title

President

Phone

(602) 717-4751

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Aviant Hospice Gila Doing business as

Listed as

Aviant Hospice GilaCCN 031582

Ownership

For-Profit

Certified

Mar 19, 2009

Medicare certification status

ActiveFrom the Provider of Services file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1952578957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S. STAPLEY DR.",
            "address_2": "STE. 245",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046667",
            "telephone_number": "480-383-8599",
            "fax_number": "480-398-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S BROAD ST",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855012602",
            "telephone_number": "928-425-5400",
            "fax_number": "928-425-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF THE SOUTHWEST - WEST VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-717-4751"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC6544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429014",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aviant Hospice Gila",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.