=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033248661
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMFORT HOSPICE CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1425 S 1500 E
-----------------------------------------------------
City | CLEARFIELD
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84015-1621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-525-8800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6655 W SAHARA AVE STE 113
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89146-0842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-233-9800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | CAROL H ERRISSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-233-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------