Healthcare Provider Details

I. General information

NPI: 1164274650
Provider Name (Legal Business Name): COMFORT HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30555 SOUTHFIELD RD STE 150
SOUTHFIELD MI
48076-7700
US

IV. Provider business mailing address

30555 SOUTHFIELD RD STE 150
SOUTHFIELD MI
48076-7700
US

V. Phone/Fax

Practice location:
  • Phone: 248-905-5295
  • Fax: 248-905-5003
Mailing address:
  • Phone: 248-905-5295
  • Fax: 248-905-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA ANN WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-905-5295