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General NPI Number Information
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NPI Number | 1457271553
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Entity Type | Organization
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Legal Business Name | MARK COMFORT HOME
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Dates
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Enumeration Date | 07/18/2026
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Last Update Date | 07/18/2026
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Provider Practice Location Address
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Address Line | 5295 WILLOW LEAF ST N
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City | KEIZER
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State | OR
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Zip | 97303-7518
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Country | US
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Telephone | 503-390-2110
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Fax | 971-343-2977
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Provider Business Mailing Address
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Address Line | 5295 WILLOW LEAF ST N
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City | KEIZER
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State | OR
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Zip | 97303-7518
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Country | US
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Telephone | 503-390-2110
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Fax | 971-343-2977
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Authorized Official
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Title or Position | OWNER
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Name | JEAN PIERRE RUGWIZANGOGA
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Credential |
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Telephone | 502-936-9618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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