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General NPI Number Information
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NPI Number | 1265747810
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Entity Type | Organization
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Legal Business Name | COMFORTS OF HOME ADULT DAYCARE, LLC
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 08/20/2011
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Provider Practice Location Address
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Address Line | 4317 HIGHWAY P
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City | HALF WAY
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State | MO
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Zip | 65663-9130
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Country | US
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Telephone | 417-445-3173
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Fax | 417-445-3173
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Provider Business Mailing Address
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Address Line | 4317 HIGHWAY P
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City | HALF WAY
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State | MO
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Zip | 65663-9130
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Country | US
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Telephone | 417-445-3173
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Fax | 417-445-3173
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Authorized Official
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Title or Position | OWNER
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Name | TONI M GREER
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Credential |
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Telephone | 417-445-3173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 27056
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License Number State | MO
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