Active NPI
Lavender Hospice LLC
- Community Based Hospice Care Agency
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- LAVENDER HOSPICE LLC
- Practice address
- 20815 N 25TH Place
Suite A106
Phoenix, AZ 85050-4617 - Phone
- (602) 283-3663
- Fax
- (602) 283-3682
- NPI assigned
- Nov 7, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Roselavender Richards
- Title
- Owner
- Phone
- (602) 283-3683
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
20815 N 25TH Place
Suite A106
Phoenix, AZ 85050-4617
Mailing address
20815 N 25TH Place
Suite A106
Phoenix, AZ 85050-4617
Phone (602) 283-3663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211630 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180917000291 | AZ | Part A Provider - Hospice | 2264783190 | Practice locations: Phoenix, AZ |
Hospice certification: CCN 031693
- Legal name
- LAVENDER HOSPICE LLC
- Doing business as
- LAVENDER HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 19, 2019
- Last certification
- Mar 19, 2019
- Ownership / control type
- Other
- Organization structure
- LLC
- Incorporated
- Aug 21, 2017 in AZ
- Enrollment address
- 20815 N 25TH PL
Ste A106
Phoenix, AZ 85050-4617
Care Compare: Hospice
Medicare Care Compare- Listed as
- Lavender Hospice
- Ownership
- Other
- Certified
- Mar 19, 2019
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2142318 | Lavender Hospice LLC | Certificate of waiver | Jan 8, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
20815 N 25th Pl
Ste A106
Phoenix, AZ 85050
Phone (602) 283-9898
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Roselavender a Richards | 5% Or Greater Direct Ownership Interest | Jul 31, 2023 | 100% |
| Corporate Officer | Jul 31, 2023 | 100% | |
| Corporate Director | Jul 31, 2023 | 100% | |
| W-2 Managing Employee | Oct 1, 2017 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1417934902
5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1417934902
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510012800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783987200000",
"number": "1982117305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20815 N 25TH PLACE",
"address_2": "SUITE A106",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504617",
"telephone_number": "602-283-3663",
"fax_number": "602-283-3682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20815 N 25TH PLACE",
"address_2": "SUITE A106",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504617",
"telephone_number": "602-283-3663",
"fax_number": "602-283-3682"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAVENDER HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-07",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A",
"authorized_official_last_name": "RICHARDS",
"authorized_official_first_name": "ROSELAVENDER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "602-283-3683",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211630",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.