Healthcare Provider Details

I. General information

NPI: 1689239873
Provider Name (Legal Business Name): CENTERFIELD HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 S 900 E STE 202
ST GEORGE UT
84790-7003
US

IV. Provider business mailing address

354 W CENTERFIELD CIR
WASHINGTON UT
84780-8483
US

V. Phone/Fax

Practice location:
  • Phone: 435-359-4599
  • Fax:
Mailing address:
  • Phone: 435-359-4599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CLINT JOHN HOOPES
Title or Position: ADMINISTRATOR / OWNER
Credential:
Phone: 435-359-4599