Provider Demographics
NPI:1356440960
Name:SK WYATT INC
Entity Type:Organization
Organization Name:SK WYATT INC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VP/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-578-7778
Mailing Address - Street 1:PO BOX 7920
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903
Mailing Address - Country:US
Mailing Address - Phone:361-578-7778
Mailing Address - Fax:361-578-5248
Practice Address - Street 1:1007 E AIRLINE
Practice Address - Street 2:STE A
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-578-7778
Practice Address - Fax:361-578-5248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010057171W00000X
TX014889171W00000X
253Z00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care