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General NPI Number Information
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NPI Number | 1003617762
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Entity Type | Organization
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Legal Business Name | AMAZING COMFORT CARE LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1860 SW FOUNTAINVIEW BLVD STE 100
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-4528
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Country | US
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Telephone | 772-301-9461
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Fax | 772-405-2798
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Provider Business Mailing Address
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Address Line | 1860 SW FOUNTAINVIEW BLVD STE 100
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-4528
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Country | US
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Telephone | 772-301-9461
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Fax | 772-405-2798
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Authorized Official
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Title or Position | OWNER
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Name | OMAMEZI OLOKOR
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Credential |
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Telephone | 772-301-9461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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