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General NPI Number Information
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NPI Number | 1073011268
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Entity Type | Organization
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Legal Business Name | AT HOME COMFORT CARE LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 1042 ANSEL RD
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City | CLEVELAND
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State | OH
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Zip | 44103-2268
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Country | US
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Telephone | 216-235-2429
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Fax | 216-235-2429
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Provider Business Mailing Address
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Address Line | 1042 ANSEL RD
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City | CLEVELAND
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State | OH
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Zip | 44103-2268
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPN SOLE MEMBER
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Name | NICOLETTE WALKER
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Credential |
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Telephone | 216-235-2429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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