Healthcare Provider Details

I. General information

NPI: 1265747810
Provider Name (Legal Business Name): COMFORTS OF HOME ADULT DAYCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 HIGHWAY P
HALF WAY MO
65663-9130
US

IV. Provider business mailing address

4317 HIGHWAY P
HALF WAY MO
65663-9130
US

V. Phone/Fax

Practice location:
  • Phone: 417-445-3173
  • Fax: 417-445-3173
Mailing address:
  • Phone: 417-445-3173
  • Fax: 417-445-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number27056
License Number StateMO

VIII. Authorized Official

Name: TONI M GREER
Title or Position: OWNER
Credential:
Phone: 417-445-3173