Provider Demographics
NPI:1689022337
Name:COMFORT & CARE SERVICES, LLC
Entity Type:Organization
Organization Name:COMFORT & CARE SERVICES, LLC
Other - Org Name:COMFORT & CARE TAXI SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERVON
Authorized Official - Middle Name:TANYA
Authorized Official - Last Name:DUBIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:757-329-1504
Mailing Address - Street 1:3630 S PLAZA TRL
Mailing Address - Street 2:SUITE 210J
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-3300
Mailing Address - Country:US
Mailing Address - Phone:757-499-1273
Mailing Address - Fax:757-340-4095
Practice Address - Street 1:3630 S PLAZA TRL
Practice Address - Street 2:SUITE 210J
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3300
Practice Address - Country:US
Practice Address - Phone:757-499-1273
Practice Address - Fax:757-340-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA25325344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA208407Medicaid