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General NPI Number Information
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NPI Number | 1265183081
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Entity Type | Organization
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Legal Business Name | COMFORT AT HOME SENIOR CARE, LLC
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 9951 ATLANTIC BLVD STE 255
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City | JACKSONVILLE
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State | FL
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Zip | 32225-6589
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Country | US
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Telephone | 868-554-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 11286 WILLESDON DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32246-0531
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Country | US
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Telephone | 386-855-4703
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | SONYA L MCMILLAN
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Credential |
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Telephone | 386-855-4703
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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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Taxonomy #2
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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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