Provider Demographics
NPI:1407219082
Name:COZY HOME LIVING, LLC
Entity Type:Organization
Organization Name:COZY HOME LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCIA
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:240-394-6359
Mailing Address - Street 1:11431 AMHERST AVE PO BOX #1996
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20915
Mailing Address - Country:US
Mailing Address - Phone:240-394-6359
Mailing Address - Fax:
Practice Address - Street 1:11431 AMHERST AVE #1996
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20915
Practice Address - Country:US
Practice Address - Phone:240-394-6359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility