Provider Demographics
NPI:1528216066
Name:HOME COMFORTS
Entity Type:Organization
Organization Name:HOME COMFORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSONAL CARE ATTENDANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-813-7825
Mailing Address - Street 1:PO BOX 36221
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6221
Mailing Address - Country:US
Mailing Address - Phone:702-813-7825
Mailing Address - Fax:702-471-0010
Practice Address - Street 1:513 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3642
Practice Address - Country:US
Practice Address - Phone:702-813-7825
Practice Address - Fax:702-471-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5626213167302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV56262167Medicaid