Provider Demographics
NPI:1396460309
Name:COLEMAN COMFORT CARE
Entity type:Organization
Organization Name:COLEMAN COMFORT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH CARE AID
Authorized Official - Prefix:
Authorized Official - First Name:WRAENIQUE SHARON
Authorized Official - Middle Name:LYKE
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-340-3697
Mailing Address - Street 1:3032 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-2920
Mailing Address - Country:US
Mailing Address - Phone:231-340-3697
Mailing Address - Fax:
Practice Address - Street 1:3032 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-2920
Practice Address - Country:US
Practice Address - Phone:616-987-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health