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General NPI Number Information
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NPI Number | 1861989998
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Entity Type | Organization
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Legal Business Name | COMFORT 1 HOSPICE, LLC
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Dates
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Enumeration Date | 04/14/2018
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Last Update Date | 04/14/2018
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Provider Practice Location Address
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Address Line | 129 S DIXIE WAY STE B
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City | SOUTH BEND
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State | IN
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Zip | 46637-3392
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Country | US
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Telephone | 574-387-4117
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Fax |
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Provider Business Mailing Address
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Address Line | 129 S DIXIE WAY STE B
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City | SOUTH BEND
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State | IN
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Zip | 46637-3392
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Country | US
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Telephone | 574-387-4117
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PAUL CHIMUTU
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Credential |
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Telephone | 574-387-4117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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