Provider Demographics
NPI:1487231973
Name:COMPREHENSIVE MENTAL AND FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:COMPREHENSIVE MENTAL AND FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:HILLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-806-2954
Mailing Address - Street 1:780 N 2860 E STE 202
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8707
Mailing Address - Country:US
Mailing Address - Phone:435-572-0795
Mailing Address - Fax:
Practice Address - Street 1:780 N 2860 E STE 202
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8707
Practice Address - Country:US
Practice Address - Phone:435-572-0795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1992959324Medicaid