Provider Demographics
NPI:1326660762
Name:COMFORT SISI HEALTHCARE, LLC
Entity Type:Organization
Organization Name:COMFORT SISI HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:SEKYERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-222-7732
Mailing Address - Street 1:8609 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-4409
Mailing Address - Country:US
Mailing Address - Phone:301-222-7732
Mailing Address - Fax:301-328-0406
Practice Address - Street 1:8609 34TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-4409
Practice Address - Country:US
Practice Address - Phone:301-222-7732
Practice Address - Fax:301-328-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities