| Name: | Comfort Care Hospice, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 Sep 1999 (25 years ago) |
| Entity Number: | 000-666-550 |
| Register Number: | 000666550 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Cullman County |
| Principal Address: | 400 Interstate North Parkway SEAtlanta, GA 30339 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
PROVIDE HOSPICE SERVICES FOR PATIENTS
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DVNUFHV371M9 | 2024-08-23 | 245 CAHABA VALLEY PKWY STE 110, PELHAM, AL, 35124, 2217, USA | 400 INTERSTATE NORTH PARKWAY SE, SUITE 1600, ATLANTA, GA, 30339, USA | |||||||||||||||||||||||||||||||||||||
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| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-09-05 |
| Initial Registration Date | 2021-05-25 |
| Entity Start Date | 1999-09-28 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621610 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SHAWNA JOHNSON |
| Address | 400 INTERSTATE NORTH PARKWAY SE, SUITE 1600, ATLANTA, GA, 30339, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MICHAEL JABOUR |
| Address | 400 INTERSTATE NORTH PARKWAY SE, SUITE 1600, ATLANTA, GA, 30339, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457384844 | 2006-07-08 | 2023-09-21 | 400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA, 303395047, US | 23730 JOHN T REID PKWY STE A, SCOTTSBORO, AL, 357682840, US | |||||||||||||||||||||||||||
|
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| Phone | +1 470-464-8000 |
| Phone | +1 256-259-0906 |
| Fax | 2562590907 |
Authorized person
| Name | SHANNON DRAKE |
| Role | CHIEF LEGAL OFFICER |
| Phone | 4704648000 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11667 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1635E |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| BROWN, R FRANK JR | Member | 401 ARNOLD STREETCULLMAN, AL 35086 |
| SMITH, JERRY C JR | Member | No data |
| ESTES, J NORMAN | Member | 931 FAIRFAX PARKTUSCALOOSA, AL 35406 |
| BENTON, KEITH | Member | No data |
| ESTES, DAVID | Member | No data |
| BAKER, ALEX | Member | No data |
| BURCHFIELD, JOHN | Member | 931 FAIRFAX PARKTUSCALOOSA, AL 35406 |
| JONES, JOSEPH W JR | Member | 501 WHETSTONE STMONROEVILLE, AL 36460 |
| KEEFER, LARRY | Member | No data |
| MCABEE, DAVID | Member | No data |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
