Healthcare Provider Details

I. General information

NPI: 1033481189
Provider Name (Legal Business Name): COMFORT CARE IN HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MARKET ST
SUFFOLK VA
23434-5209
US

IV. Provider business mailing address

201 MARKET ST
SUFFOLK VA
23434-5209
US

V. Phone/Fax

Practice location:
  • Phone: 757-923-2980
  • Fax: 757-923-2982
Mailing address:
  • Phone: 757-923-2980
  • Fax: 757-923-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. ANNETTE GOODMAN
Title or Position: OWNER
Credential:
Phone: 757-923-2980