Provider Demographics
NPI:1205141272
Name:COMFORT AT HOME
Entity type:Organization
Organization Name:COMFORT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PERINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-335-5887
Mailing Address - Street 1:2600 POPLAR AVE
Mailing Address - Street 2:6E
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3851
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2258 LANSINGWOOD DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-5241
Practice Address - Country:US
Practice Address - Phone:901-335-5887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services