Provider Demographics
NPI:1811348055
Name:COMMUNITY COMFORT CARE INCORPORATED
Entity type:Organization
Organization Name:COMMUNITY COMFORT CARE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-210-7961
Mailing Address - Street 1:4545 NW 103RD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7947
Mailing Address - Country:US
Mailing Address - Phone:954-210-7961
Mailing Address - Fax:954-210-7974
Practice Address - Street 1:4545 NW 103RD AVE STE 200
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7947
Practice Address - Country:US
Practice Address - Phone:954-210-7961
Practice Address - Fax:954-210-7974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211693251J00000X, 253Z00000X, 347C00000X
FL233553253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100294800Medicaid
FL101435700Medicaid