| Organization Name: | CELESTIAL COMFORT CARE HOSPICE |
| NPI Number: | 1205186947 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETTY GOOCH (CEO) |
| Mailing Address: | 110 Yazoo Ave. Suite 212 Clarksdale |
| State: | MS US |
| Postal Code: | 38614 |
| Phone Number: | 6625924213 |
| Fax Number: | 6625924210 |
| NPI Enumeration Date: | 09/10/2012 |
| NPI Last Update Date: | 09/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 205 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |