Provider Demographics
NPI:1407364821
Name:CHESANING COMFORT CARE
Entity Type:Organization
Organization Name:CHESANING COMFORT CARE
Other - Org Name:COMFORT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRIMSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-607-0011
Mailing Address - Street 1:1800 W BRADY RD
Mailing Address - Street 2:
Mailing Address - City:CHESANING
Mailing Address - State:MI
Mailing Address - Zip Code:48616
Mailing Address - Country:US
Mailing Address - Phone:989-607-0011
Mailing Address - Fax:989-323-2318
Practice Address - Street 1:1800 W BRADY RD
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616
Practice Address - Country:US
Practice Address - Phone:989-607-0011
Practice Address - Fax:989-323-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty