Provider Demographics
NPI:1003559998
Name:GRANDMAS COMFORT & CARING HAND, LLC
Entity Type:Organization
Organization Name:GRANDMAS COMFORT & CARING HAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUTRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-470-6190
Mailing Address - Street 1:5944 LOCKAMY LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2709
Mailing Address - Country:US
Mailing Address - Phone:757-470-6190
Mailing Address - Fax:
Practice Address - Street 1:5944 LOCKAMY LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2709
Practice Address - Country:US
Practice Address - Phone:757-470-6190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities