Provider Demographics
NPI:1891171013
Name:KOMFORT KEYPERS LLC
Entity Type:Organization
Organization Name:KOMFORT KEYPERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUMMERS BETHUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-647-4513
Mailing Address - Street 1:5311 NORTHFIELD RD
Mailing Address - Street 2:SUITE 405 B
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1188
Mailing Address - Country:US
Mailing Address - Phone:216-510-7778
Mailing Address - Fax:
Practice Address - Street 1:5311 NORTHFIELD RD
Practice Address - Street 2:SUITE 405 B
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1188
Practice Address - Country:US
Practice Address - Phone:216-510-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343800000XTransportation ServicesSecured Medical Transport (VAN)