Provider Demographics
NPI:1083940662
Name:COMFORT 4 MOM AND BABY LLC
Entity Type:Organization
Organization Name:COMFORT 4 MOM AND BABY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-613-9440
Mailing Address - Street 1:17250 W 12 MILE RD
Mailing Address - Street 2:SUITE122
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2127
Mailing Address - Country:US
Mailing Address - Phone:248-613-9440
Mailing Address - Fax:248-905-5003
Practice Address - Street 1:17250 W 12 MILE RD
Practice Address - Street 2:SUITE122
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2127
Practice Address - Country:US
Practice Address - Phone:248-613-9440
Practice Address - Fax:248-905-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency