Provider Demographics
NPI:1629579016
Name:YOUR COMFORT CARE IN HOME SERVICE LLC
Entity Type:Organization
Organization Name:YOUR COMFORT CARE IN HOME SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CAVETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-222-0052
Mailing Address - Street 1:11469 OLIVE BLVD
Mailing Address - Street 2:201
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7108
Mailing Address - Country:US
Mailing Address - Phone:314-222-0052
Mailing Address - Fax:314-222-0058
Practice Address - Street 1:10425 OLD OLIVE STREET ROAD
Practice Address - Street 2:207
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-5940
Practice Address - Country:US
Practice Address - Phone:314-222-0052
Practice Address - Fax:314-222-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health