Provider Demographics
NPI:1508435108
Name:CASTLE COMFORT HOMECARE LLC
Entity Type:Organization
Organization Name:CASTLE COMFORT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:MACKELVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JNO-CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-464-1819
Mailing Address - Street 1:12553 NEW BRITTANY BLVD # 3211
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3625
Mailing Address - Country:US
Mailing Address - Phone:239-464-1819
Mailing Address - Fax:
Practice Address - Street 1:12553 NEW BRITTANY BLVD # 3211
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3625
Practice Address - Country:US
Practice Address - Phone:239-464-1819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-18
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care