Provider Demographics
NPI:1467810010
Name:NIX JT CORP., DBA COMFORT KEEPERS 685
Entity Type:Organization
Organization Name:NIX JT CORP., DBA COMFORT KEEPERS 685
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-272-0444
Mailing Address - Street 1:179 GRAHAM ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-272-0444
Mailing Address - Fax:607-272-7710
Practice Address - Street 1:179 GRAHAM ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-272-0444
Practice Address - Fax:607-272-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2080L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health