Provider Demographics
NPI:1881603280
Name:UNITED COMFORT CARE, INC
Entity type:Organization
Organization Name:UNITED COMFORT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:BUKOLA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-206-0448
Mailing Address - Street 1:5312 FREESTONE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-2672
Mailing Address - Country:US
Mailing Address - Phone:972-206-0448
Mailing Address - Fax:972-206-0131
Practice Address - Street 1:5312 FREESTONE DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-2672
Practice Address - Country:US
Practice Address - Phone:972-206-0448
Practice Address - Fax:972-206-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X
TX010313251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453134Medicare Oscar/Certification
TX453134Medicare ID - Type UnspecifiedPROVIDER NUMBER