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General NPI Number Information
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NPI Number | 1366230427
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Entity Type | Organization
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Legal Business Name | CAMILLE COMFORT CARE SERVICES
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 273 JARRELL RD
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City | KOKOMO
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State | MS
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Zip | 39643-5015
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Country | US
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Telephone | 601-910-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 29 SUNLIGHT CHURCH RD
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City | SANDY HOOK
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State | MS
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Zip | 39478-9469
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Country | US
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Telephone | 601-810-1191
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Fax | 601-395-6849
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LATONYA C MARK
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Credential |
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Telephone | 601-810-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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