Provider Demographics
NPI:1902180664
Name:WITKIEWICZ ENTERPRISES, INC
Entity Type:Organization
Organization Name:WITKIEWICZ ENTERPRISES, INC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KUJAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-354-0102
Mailing Address - Street 1:240 CHEROKEE ST NE STE 302
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1628
Mailing Address - Country:US
Mailing Address - Phone:678-354-0102
Mailing Address - Fax:678-354-0014
Practice Address - Street 1:240 CHEROKEE ST NE STE 302
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1628
Practice Address - Country:US
Practice Address - Phone:678-354-0102
Practice Address - Fax:678-354-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0092253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care