Provider Demographics
NPI:1972855336
Name:COMFORT HEALTHCARE THERAPY LLC
Entity Type:Organization
Organization Name:COMFORT HEALTHCARE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEYINWA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NZEREM
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CLT
Authorized Official - Phone:765-683-0633
Mailing Address - Street 1:714 W 53RD ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-1514
Mailing Address - Country:US
Mailing Address - Phone:765-683-0633
Mailing Address - Fax:765-683-0603
Practice Address - Street 1:714 W 53RD ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-1514
Practice Address - Country:US
Practice Address - Phone:765-683-0633
Practice Address - Fax:765-683-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)