Provider Demographics
NPI:1063030294
Name:MINDFUL COMFORTS LLC
Entity Type:Organization
Organization Name:MINDFUL COMFORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:GROSSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:732-501-8349
Mailing Address - Street 1:150 SANTIAGO AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1640
Mailing Address - Country:US
Mailing Address - Phone:732-501-8349
Mailing Address - Fax:
Practice Address - Street 1:67 HOME AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1727
Practice Address - Country:US
Practice Address - Phone:732-355-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center