Healthcare Provider Details

I. General information

NPI: 1477368884
Provider Name (Legal Business Name): DAVIS COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10323 SLADDEN AVE
CLEVELAND OH
44125-1560
US

IV. Provider business mailing address

10323 SLADDEN AVE
CLEVELAND OH
44125-1560
US

V. Phone/Fax

Practice location:
  • Phone: 216-288-4997
  • Fax:
Mailing address:
  • Phone: 216-288-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. LANIECE DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 216-288-4997