Healthcare Provider Details

I. General information

NPI: 1811769714
Provider Name (Legal Business Name): COMFORT COMPANIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 WESTINGHOUSE RD
PENDLETON SC
29670-8839
US

IV. Provider business mailing address

310 WESTINGHOUSE RD
PENDLETON SC
29670-8839
US

V. Phone/Fax

Practice location:
  • Phone: 864-399-7034
  • Fax:
Mailing address:
  • Phone: 864-359-4469
  • Fax: 864-399-7036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NIQUESHA MICOLE BROWN
Title or Position: OWNER
Credential:
Phone: 864-359-4469