Healthcare Provider Details

I. General information

NPI: 1659286045
Provider Name (Legal Business Name): JOHN COMEAU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 CAPITAL AVE SW
BATTLE CREEK MI
49015-3818
US

IV. Provider business mailing address

971 CAPITAL AVE SW
BATTLE CREEK MI
49015-3818
US

V. Phone/Fax

Practice location:
  • Phone: 978-490-6564
  • Fax: 269-753-1994
Mailing address:
  • Phone: 978-490-6564
  • Fax: 269-753-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberAF130385087
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: