Provider Demographics
NPI:1669822730
Name:COMFORT SENIOR CARE LLC
Entity Type:Organization
Organization Name:COMFORT SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZZY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHKUASELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-251-1964
Mailing Address - Street 1:1820 AMWELL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2790
Mailing Address - Country:US
Mailing Address - Phone:917-251-1964
Mailing Address - Fax:
Practice Address - Street 1:1820 AMWELL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2790
Practice Address - Country:US
Practice Address - Phone:917-251-1964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health