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General NPI Number Information
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NPI Number | 1225596307
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Entity Type | Organization
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Legal Business Name | COMFORT AT HOME PRIVATE HOMECARE, LLC
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 289 JONESBORO RD STE 643
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City | MCDONOUGH
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State | GA
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Zip | 30253-3725
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Country | US
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Telephone | 770-288-5101
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Fax |
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Provider Business Mailing Address
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Address Line | 289 JONESBORO RD STE 643
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City | MCDONOUGH
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State | GA
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Zip | 30253-3725
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Country | US
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Telephone | 770-288-5101
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | EDDALISA LLOYD
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Credential |
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Telephone | 678-557-1384
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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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