Provider Demographics
NPI:1013241066
Name:COMFORT COMPANION CHOICE INC
Entity Type:Organization
Organization Name:COMFORT COMPANION CHOICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA SHON
Authorized Official - Middle Name:
Authorized Official - Last Name:GURROLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-386-3324
Mailing Address - Street 1:818 HARRISON ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1144
Mailing Address - Country:US
Mailing Address - Phone:708-386-3324
Mailing Address - Fax:708-386-3397
Practice Address - Street 1:818 HARRISON ST
Practice Address - Street 2:SUITE 206
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1144
Practice Address - Country:US
Practice Address - Phone:708-386-3324
Practice Address - Fax:708-386-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty