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General NPI Number Information
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NPI Number | 1396460309
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Entity Type | Organization
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Legal Business Name | COLEMAN COMFORT CARE
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 3032 JEFFERSON ST
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City | MUSKEGON
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State | MI
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Zip | 49444-2920
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Country | US
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Telephone | 616-987-0063
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Fax |
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Provider Business Mailing Address
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Address Line | 3032 JEFFERSON ST
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City | MUSKEGON
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State | MI
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Zip | 49444-2920
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Country | US
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Telephone | 231-340-3697
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Fax |
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Authorized Official
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Title or Position | HEALTH CARE AID
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Name | WRAENIQUE SHARON LYKE COLEMAN
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Credential |
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Telephone | 231-340-3697
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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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