Provider Demographics
NPI:1790562940
Name:COMFORT HANDS OF GRACE
Entity Type:Organization
Organization Name:COMFORT HANDS OF GRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-545-8133
Mailing Address - Street 1:4005 MOFFETT RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-1213
Mailing Address - Country:US
Mailing Address - Phone:251-545-8133
Mailing Address - Fax:
Practice Address - Street 1:2084 REDPINE DR
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-7368
Practice Address - Country:US
Practice Address - Phone:251-545-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health