=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306220959
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMAZING COMFORT HOME CARE SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2015
-----------------------------------------------------
Last Update Date | 07/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12115 SWEET CLOVER DR
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20904-1828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-338-0269
-----------------------------------------------------
Fax | 301-586-0270
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12115 SWEET CLOVER DR
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20904-1828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-338-0269
-----------------------------------------------------
Fax | 301-586-0270
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEAN CARLOS SYLVAIN
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 240-338-0269
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | R3782P
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------