Provider Demographics
NPI:1417145236
Name:COMFORTSTAY ASSISTANCE FLORIDA, INC
Entity Type:Organization
Organization Name:COMFORTSTAY ASSISTANCE FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-760-0400
Mailing Address - Street 1:2090 S NOVA RD
Mailing Address - Street 2:SUITE AA20
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8834
Mailing Address - Country:US
Mailing Address - Phone:386-760-0400
Mailing Address - Fax:386-760-0401
Practice Address - Street 1:2090 S NOVA RD
Practice Address - Street 2:SUITE AA20
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-8834
Practice Address - Country:US
Practice Address - Phone:386-760-0400
Practice Address - Fax:386-760-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230152251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health