Provider Demographics
NPI:1467698019
Name:COMFORT CARE IN HOME SERVICES INC.
Entity Type:Organization
Organization Name:COMFORT CARE IN HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-335-0986
Mailing Address - Street 1:2021 PERRYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701
Mailing Address - Country:US
Mailing Address - Phone:573-335-0986
Mailing Address - Fax:573-339-0112
Practice Address - Street 1:1858 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4553
Practice Address - Country:US
Practice Address - Phone:573-335-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0009798171M00000X
MO2000166148251G00000X, 251J00000X, 253Z00000X
MO0097983140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, PediatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0009798Medicaid