Provider Demographics
NPI:1487208112
Name:COMFORT LIFE CARE ADULT MEDICAL DAY CARE
Entity Type:Organization
Organization Name:COMFORT LIFE CARE ADULT MEDICAL DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASWANT
Authorized Official - Middle Name:
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-449-1586
Mailing Address - Street 1:11221 DOLFIELD BLVD STE 100-101
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3254
Mailing Address - Country:US
Mailing Address - Phone:443-449-1586
Mailing Address - Fax:
Practice Address - Street 1:11221 DOLFIELD BLVD STE 100-101
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3254
Practice Address - Country:US
Practice Address - Phone:443-449-1586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care