LHCG CLXXII LLC NPI 1407458532

NPI Information

LHCG CLXXII, LLC is a family nurse practitioner in Mesa, AZ. LHCG CLXXII, LLC NPI is 1407458532. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Casa De La Luz Palliative Care.

The provider's business location address is:

2152 S VINEYARD STE 118
MESA, AZ
ZIP 85210-881
Phone: (480) 895-5434
Fax: (480) 305-5782

The provider's authorized official is Joshua L Proffitt .
The authorized official title is President and has the following contact phone number (337) 233-1307.

The CLIA number assigned to this NPI record is 03D1080016 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/13/2020 and was last updated on 3/27/2023.

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:

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