Provider Demographics
NPI:1811699622
Name:COMFORT CARE RECOVERY CENTER
Entity type:Organization
Organization Name:COMFORT CARE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHAREE
Authorized Official - Middle Name:CHEVAUGHN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-729-4221
Mailing Address - Street 1:1255 N ARIZONA AVE UNIT 1066
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0704
Mailing Address - Country:US
Mailing Address - Phone:212-729-4221
Mailing Address - Fax:
Practice Address - Street 1:1255 N ARIZONA AVE UNIT 1066
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0704
Practice Address - Country:US
Practice Address - Phone:212-729-4221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery CareGroup - Multi-Specialty