Provider Demographics
NPI:1922424845
Name:AGING WITH COMFORT
Entity Type:Organization
Organization Name:AGING WITH COMFORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-740-5785
Mailing Address - Street 1:8302 BUSTLETON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1909
Mailing Address - Country:US
Mailing Address - Phone:215-745-5555
Mailing Address - Fax:
Practice Address - Street 1:8302 BUSTLETON AVE FL 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1909
Practice Address - Country:US
Practice Address - Phone:215-745-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25223601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care