Comfortbrook Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

COMFORTBROOK HOSPICE, LLC

Doing business as

Grace Hospice

Practice address

1900 Indian Wood Cir Ste 202a
Maumee, OH 43537-4039

Phone

(567) 218-2075

Fax

(877) 473-8167

NPI assigned

May 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Chance

Title

Ceo/Authorized Official

Phone

(248) 824-6004

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Grace Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Residential Hospice, LLC

  • Community Based Hospice Care Agency
  • Maumee, OH
  • NPI 1891413597

  Sold to, 2022-08-26

  CMS change of ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1649482621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 99278",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480999278",
            "telephone_number": "248-824-6609",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 INDIAN WOOD CIR STE 202A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374039",
            "telephone_number": "567-218-2075",
            "fax_number": "877-473-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORTBROOK HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "CHANCE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "248-824-6004"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO HOSPICE LICENSE",
            "identifier": "0193HSP",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2889674",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH TDDD",
            "identifier": "FCY.022229050-12",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelica L Collins, CNP
• Peggy Collins, PTA
• Colon, Rectal and Laser Surgery Associates, Inc.
• Karen Colton
• Gwendolyn Leigh Colyer, CRNA
• Community Therapy Services, LLC
• Comprehensive Rehabilitation Group Inc
• Jillian Elizabeth Condon, RN
• Kim Confer-Seeley, MD
• Heidi Ann Conklin, CNP

• Community Based Hospice Care Agency in Maumee, OH
• Providers in Maumee, OH by specialty
• Community Based Hospice Care Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.