Provider Demographics
NPI:1942584347
Name:COUNTRY HOME COMFORTS LLC
Entity Type:Organization
Organization Name:COUNTRY HOME COMFORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:320-679-2847
Mailing Address - Street 1:1784 OLYMPIC STREET
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051
Mailing Address - Country:US
Mailing Address - Phone:320-679-2847
Mailing Address - Fax:
Practice Address - Street 1:2656 RAINBOW STREET
Practice Address - Street 2:COUNTRY HOME COMFORTS LLC
Practice Address - City:BROOK PARK
Practice Address - State:MN
Practice Address - Zip Code:55007
Practice Address - Country:US
Practice Address - Phone:320-679-2847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCLASSF349194310400000X
MNHWS350777310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility