Healthcare Provider Details

I. General information

NPI: 1710354840
Provider Name (Legal Business Name): COMFORT LIFE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 ROOSEVELT BLVD
ELKRIDGE MD
21075-6326
US

IV. Provider business mailing address

7320 ROOSEVELT BLVD
ELKRIDGE MD
21075-6326
US

V. Phone/Fax

Practice location:
  • Phone: 410-796-1188
  • Fax:
Mailing address:
  • Phone: 410-796-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberAM20154
License Number StateMD

VIII. Authorized Official

Name: MR. WALKER SYED
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 410-796-1188