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General NPI Number Information
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NPI Number | 1295891489
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Entity Type | Organization
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Legal Business Name | COMFORT MANOR CARE
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7611D RICHMOND HWY
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City | ALEXANDRIA
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State | VA
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Zip | 22306-2847
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Country | US
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Telephone | 703-349-5313
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Fax |
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Provider Business Mailing Address
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Address Line | 5837 FIFER DR
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1916
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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 | OWNER
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Name | SAMUEL O NYARKO
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Credential |
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Telephone | 703-349-5313
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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 | 251E00000X
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License Number State | VA
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