Provider Demographics
NPI:1972508091
Name:COMFORT CARE HOSPICE, LLC
Entity type:Organization
Organization Name:COMFORT CARE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:VISKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-766-4100
Mailing Address - Street 1:728 E 2900 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3927
Mailing Address - Country:US
Mailing Address - Phone:801-766-4100
Mailing Address - Fax:801-766-9253
Practice Address - Street 1:728 E 2900 N
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-3927
Practice Address - Country:US
Practice Address - Phone:801-766-4100
Practice Address - Fax:801-766-9253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT461525Medicare ID - Type UnspecifiedLEGACY