MEDICARE: COMFORT BRIDGE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144176413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT BRIDGE HOME CARE LLC

Provider Business Mailing Address
First Line	:	6422 WINTER ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-3618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 E PAULDING RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-1103
Country	:	US
Telephone Number	:	260-479-8827
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	KO DEIN DAN
Credential	:
Telephone Number	:	260-479-8827

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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