Provider Demographics
NPI:1811464928
Name:COMFORTABLE HOME CARE LLC
Entity type:Organization
Organization Name:COMFORTABLE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LASHEA
Authorized Official - Last Name:ROBINSON-PROSPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-226-8156
Mailing Address - Street 1:2420 VIRGINIA BEACH BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4057
Mailing Address - Country:US
Mailing Address - Phone:757-226-8156
Mailing Address - Fax:
Practice Address - Street 1:2420 VIRGINIA BEACH BLVD STE 128
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4057
Practice Address - Country:US
Practice Address - Phone:757-226-8156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA521045781OtherPASS PORT