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General NPI Number Information
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NPI Number | 1194380113
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Entity Type | Organization
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Legal Business Name | CENTERFIELD HEALTHCARE
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 736 S 900 E STE 202
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City | ST GEORGE
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State | UT
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Zip | 84790-7003
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Country | US
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Telephone | 435-862-5940
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Fax |
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Provider Business Mailing Address
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Address Line | 354 W CENTERFIELD CIR
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City | WASHINGTON
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State | UT
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Zip | 84780-8483
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Country | US
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Telephone | 435-359-4599
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CLINT JOHN HOOPES
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Credential |
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Telephone | 435-359-4599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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