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General NPI Number Information
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NPI Number | 1205696457
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Entity Type | Organization
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Legal Business Name | COMFORCARE HOME CARE LLC
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 1500 SHIPYARD RD
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City | CHESAPEAKE
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State | VA
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Zip | 23323-5516
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Country | US
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Telephone | 804-943-0985
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Fax |
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Provider Business Mailing Address
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Address Line | 142 PECK LN
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City | SUFFOLK
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State | VA
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Zip | 23434-7611
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Country | US
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Telephone | 804-943-0985
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OCTAVIA JACKSON
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Credential |
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Telephone | 804-943-0985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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