Provider Demographics
NPI:1417467523
Name:COMFORT AT HOME SENIOR & FAMILY CARE
Entity Type:Organization
Organization Name:COMFORT AT HOME SENIOR & FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OESTRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-588-3014
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:NEW MEMPHIS
Mailing Address - State:IL
Mailing Address - Zip Code:62266-0266
Mailing Address - Country:US
Mailing Address - Phone:618-588-3014
Mailing Address - Fax:
Practice Address - Street 1:160 S 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW MEMPHIS
Practice Address - State:IL
Practice Address - Zip Code:62266-1004
Practice Address - Country:US
Practice Address - Phone:618-588-3014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3001278253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care