Healthcare Provider Details

I. General information

NPI: 1104145085
Provider Name (Legal Business Name): THE PLACE OF COMFORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

947 LONGDALE AVE
LONGWOOD FL
32750-3284
US

IV. Provider business mailing address

947 LONGDALE AVE
LONGWOOD FL
32750-3284
US

V. Phone/Fax

Practice location:
  • Phone: 407-539-0885
  • Fax: 407-767-5163
Mailing address:
  • Phone: 407-539-0885
  • Fax: 407-767-5163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN JAEGER
Title or Position: EXECUTIVE DIRERTOR
Credential:
Phone: 407-539-0885