Healthcare Provider Details

I. General information

NPI: 1457723173
Provider Name (Legal Business Name): COMFORT LIFE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 TROY HILL DR STE A-B
ELKRIDGE MD
21075-7057
US

IV. Provider business mailing address

7180 TROY HILL DR STE A-B
ELKRIDGE MD
21075-7057
US

V. Phone/Fax

Practice location:
  • Phone: 443-449-1586
  • Fax:
Mailing address:
  • Phone: 410-579-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number13-002-A
License Number StateMD

VIII. Authorized Official

Name: MR. JASWANT DHALIWAL
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 443-449-1586