Healthcare Provider Details

I. General information

NPI: 1104749936
Provider Name (Legal Business Name): FAITH AND COMFORT LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3818 JUPITER BLVD SE
PALM BAY FL
32909-3872
US

IV. Provider business mailing address

3818 JUPITER BLVD SE
PALM BAY FL
32909-3872
US

V. Phone/Fax

Practice location:
  • Phone: 772-268-1517
  • Fax:
Mailing address:
  • Phone: 772-268-1517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: NIXIE BROWN FRASER
Title or Position: OWNER/ADMINISTRATOR
Credential: RN/ BSN
Phone: 321-327-2141