Provider Demographics
NPI:1568871002
Name:LANDRUM BLOCKWOOD HOLDINGS CORPORATION
Entity Type:Organization
Organization Name:LANDRUM BLOCKWOOD HOLDINGS CORPORATION
Other - Org Name:COMFORCARE SENIOR SERVICES - DENTON COUNTY, TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-387-9632
Mailing Address - Street 1:4309 MILLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7913
Mailing Address - Country:US
Mailing Address - Phone:469-387-9632
Mailing Address - Fax:
Practice Address - Street 1:966 N GARDEN RIDGE BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2827
Practice Address - Country:US
Practice Address - Phone:469-387-9632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care