Provider Demographics
NPI:1003659236
Name:COMFORT LIVING365HOME HEALTH CARE LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:COMFORT LIVING365HOME HEALTH CARE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN,RN
Authorized Official - Phone:678-670-7864
Mailing Address - Street 1:6770 FLORENCE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-1929
Mailing Address - Country:US
Mailing Address - Phone:404-491-9911
Mailing Address - Fax:
Practice Address - Street 1:6770 FLORENCE DR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-1929
Practice Address - Country:US
Practice Address - Phone:404-491-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health