Organization Active NPI

Lavender Hospice LLC

  • Community Based Hospice Care Agency
  • Phoenix, AZ
National Provider Identifier
1982117305
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
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

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Ms. Roselavender RichardsNPI 1417934902
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
211630MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 HospiceCCN 031693
Ownership
Other
Certified
Mar 19, 2019
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2142318Lavender Hospice LLC20815 N 25TH Place, Suite A106, Phoenix, AZ 85050Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory

Member 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.

NameRoleSinceShare
Roselavender a Richards Individual 5% Or Greater Direct Ownership Interest Jul 31, 2023 100%
Corporate OfficerCeo Jul 31, 2023 100%
Corporate Director Jul 31, 2023 100%
W-2 Managing EmployeeAdministrator/ Medical Director 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

Verify at the official NPI Registry.