| Name: | Comfort Care Coastal Hospice, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Oct 2015 (9 years ago) |
| Entity Number: | 000-346-096 |
| Register Number: | 000346096 |
| County: | Montgomery |
| Place of Formation: | Shelby County |
| Principal Address: | 400 Interstate North Parkway SEAtlanta, GA 30339 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DSEEKJHFZL65 | 2025-01-16 | 22502 US HIGHWAY 98, FAIRHOPE, AL, 36532, 6332, USA | 400 INTERSTATE NORTH PARKWAY SE, SUITE 1600, ATLANTA, GA, 30339, USA | |||||||||||||||||||||||||||||||||||||
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| Congressional District | 01 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-02-02 |
| Initial Registration Date | 2021-04-26 |
| Entity Start Date | 2015-10-02 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621610 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | NAFASI LOREGNARD |
| 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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205209509 | 2015-11-09 | 2023-09-19 | 400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA, 303395047, US | 22502 U.S. HIGHWAY 98, FAIRHOPE, AL, 36532, US | |||||||||||||||||||||||||
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| Phone | +1 470-464-8000 |
| Phone | +1 205-942-6820 |
Authorized person
| Name | SHANNON DRAKE |
| Role | CHIEF LEGAL OFFICER |
| Phone | 4704648000 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | E4903 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1502E |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| THOMPSON, CHRIS | Organizer | 1901 SIXTH AVE N STE 1400BIRMINGHAM, AL 35203 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
