Provider Demographics
NPI:1629480801
Name:THE COMFORT OF HOME, LLC
Entity Type:Organization
Organization Name:THE COMFORT OF HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-389-8787
Mailing Address - Street 1:2419 S CLEARING RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7453
Mailing Address - Country:US
Mailing Address - Phone:540-389-8787
Mailing Address - Fax:
Practice Address - Street 1:2419 S CLEARING RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7453
Practice Address - Country:US
Practice Address - Phone:540-389-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA901099253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care