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CENTRA MANAGEMENT SERVICES LLC NPI 1588279673


NPI Information

NPI: 1588279673
Provider Name: CENTRA MANAGEMENT SERVICES LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 03D2205331

Address:
4530 E SHEA BLVD STE 142
PHOENIX, AZ
ZIP 85028
Phone: (480) 320-4733
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CENTRA MANAGEMENT SERVICES LLC is a hospice care community based in Phoenix, AZ. CENTRA MANAGEMENT SERVICES LLC NPI is 1588279673. The provider is registered as an organization entity type.

The provider's business location address is:

4530 E SHEA BLVD STE 142
PHOENIX, AZ
ZIP 85028-067
Phone: (480) 320-4733
Fax: (888) 920-7164

The provider's authorized official is Jeffery Smith .
The authorized official title is Owner and has the following contact phone number (480) 320-4733.

The CLIA number assigned to this NPI record is 03D2205331 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/15/2020 and was last updated on 4/12/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251G00000XHospice Care, Community BasedYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1L21405248OTHERARIZONAHOSPICE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.