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General NPI Number Information
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NPI Number | 1417490848
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Entity Type | Organization
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Legal Business Name | A MILE OF COMFORT LLC
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Dates
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Enumeration Date | 12/03/2016
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 771 E SOUTHLAKE BLVD 209
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6341
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Country | US
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Telephone | 817-761-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 771 E SOUTHLAKE BLVD 209
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6341
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Country | US
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Telephone | 817-761-5006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YAKIA COLLIER
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Credential |
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Telephone | 682-221-9756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 017576
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 017576
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 017576
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License Number State | TX
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