Provider Demographics
NPI:1659993418
Name:COMFORT OF HOME CARE LLC
Entity Type:Organization
Organization Name:COMFORT OF HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAREKA
Authorized Official - Middle Name:SHANTYA
Authorized Official - Last Name:HEADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-321-0463
Mailing Address - Street 1:200 S HILL AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-3239
Mailing Address - Country:US
Mailing Address - Phone:704-345-2331
Mailing Address - Fax:866-203-5539
Practice Address - Street 1:200 S HILL AVE STE 222
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-3239
Practice Address - Country:US
Practice Address - Phone:434-584-9339
Practice Address - Fax:866-203-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health