Healthcare Provider Details

I. General information

NPI: 1568381341
Provider Name (Legal Business Name): COMFORT CARE ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 E XY AVE
VICKSBURG MI
49097-8747
US

IV. Provider business mailing address

1300 SHERWOOD AVE
KALAMAZOO MI
49048-1835
US

V. Phone/Fax

Practice location:
  • Phone: 269-550-6582
  • Fax:
Mailing address:
  • Phone: 269-550-6582
  • 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 Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAKIYLA BRADFORD
Title or Position: OWNER
Credential:
Phone: 269-550-6582