Healthcare Provider Details

I. General information

NPI: 1962699322
Provider Name (Legal Business Name): COMFORT FACILITATORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 EAGLES ROOST CT
RICHMOND VA
23223-1274
US

IV. Provider business mailing address

1617 EAGLES ROOST CT
RICHMOND VA
23223-1274
US

V. Phone/Fax

Practice location:
  • Phone: 804-503-7015
  • Fax:
Mailing address:
  • Phone: 804-503-7015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE COMFORT
Title or Position: OWNER
Credential:
Phone: 804-503-7015