Provider Demographics
NPI:1164733168
Name:COMFORT CARE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:COMFORT CARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7137-732-1212
Mailing Address - Street 1:13948 LEE JACKSON HWY
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-3202
Mailing Address - Country:US
Mailing Address - Phone:713-773-1212
Mailing Address - Fax:
Practice Address - Street 1:13948 LEE JACKSON HWY
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-3202
Practice Address - Country:US
Practice Address - Phone:713-773-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health