Provider Demographics
NPI:1689489643
Name:COMFORT COVENANT HEALTH CARE, LLC
Entity type:Organization
Organization Name:COMFORT COVENANT HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-335-7777
Mailing Address - Street 1:18151 W CANYON LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5105
Mailing Address - Country:US
Mailing Address - Phone:205-335-7777
Mailing Address - Fax:
Practice Address - Street 1:3039 N POST RD STE 1356
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-6543
Practice Address - Country:US
Practice Address - Phone:205-335-7777
Practice Address - Fax:602-777-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health