Healthcare Provider Details

I. General information

NPI: 1083539944
Provider Name (Legal Business Name): SONORAN COMFORT FIRST HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 E NIELSON AVE
MESA AZ
85204-1346
US

IV. Provider business mailing address

1945 E NIELSON AVE
MESA AZ
85204-1346
US

V. Phone/Fax

Practice location:
  • Phone: 480-227-8179
  • Fax:
Mailing address:
  • Phone: 480-227-8179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. REGINALD T BROCK
Title or Position: MANAGING MENBER
Credential:
Phone: 480-227-8179