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General NPI Number Information
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NPI Number | 1407109994
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Entity Type | Organization
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Legal Business Name | COMFORT CARE MINISTRY INTERNATIONAL LLC
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Dates
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Enumeration Date | 10/21/2012
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Last Update Date | 10/21/2012
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Provider Practice Location Address
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Address Line | 572 CENTENNIAL AVE
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City | TRENTON
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State | NJ
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Zip | 08629-2114
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Country | US
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Telephone | 609-954-7107
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Fax | 609-278-5750
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Provider Business Mailing Address
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Address Line | 572 CENTENNIAL AVE
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City | TRENTON
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State | NJ
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Zip | 08629-2114
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Country | US
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Telephone | 609-954-7107
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Fax | 609-278-5750
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIE JAMES AARON JR.
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Credential | RN
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Telephone | 609-954-7107
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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 | 26NO11439000
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License Number State | NJ
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