Healthcare Provider Details

I. General information

NPI: 1346376670
Provider Name (Legal Business Name): COMFORT HOSPICE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 W SAHARA AVE SUITE B114
LAS VEGAS NV
89146-0842
US

IV. Provider business mailing address

PO BOX 1365
LAYTON UT
84041-6365
US

V. Phone/Fax

Practice location:
  • Phone: 702-489-4412
  • Fax:
Mailing address:
  • Phone: 801-547-0812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number4693HPC-1
License Number StateNV

VIII. Authorized Official

Name: MS. CAROL H CABLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 510-522-2902