Organization
COMFORTBROOK HOSPICE, LLC
Active
Other names
Grace Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW CHANCE (CEO/AUTHORIZED OFFICIAL)
(248) 824-6004
Entity
Organization
Contact information
Practice address
1900 INDIAN WOOD CIR STE 202A, MAUMEE, OH 43537-4039
(567) 218-2075
(877) 473-8167
Mailing address
P.O. BOX 99278, TROY, MI 48099-9278
(248) 824-6609
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0193HSP
STATE OF OHIO HOSPICE LICENSE
OH
05
—
2889674
—
OH
01
—
FCY.022229050-12
OH TDDD
OH
Enumeration date
05/04/2007
Last updated
05/27/2022
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