Healthcare Provider Details

I. General information

NPI: 1689331639
Provider Name (Legal Business Name): SOUTHWEST COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2021
Last Update Date: 11/24/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8608 E ROANOKE AVE
SCOTTSDALE AZ
85257-1841
US

IV. Provider business mailing address

3370 N HAYDEN RD STE 123
SCOTTSDALE AZ
85251-6632
US

V. Phone/Fax

Practice location:
  • Phone: 602-615-1527
  • Fax:
Mailing address:
  • Phone: 602-615-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SAM R FERRERI
Title or Position: MEMBER / DIRECTOR
Credential:
Phone: 602-615-1527