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General NPI Number Information
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NPI Number | 1467810010
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Entity Type | Organization
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Legal Business Name | NIX JT CORP., DBA COMFORT KEEPERS 685
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 179 GRAHAM ROAD SUITE F
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City | ITHACA
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State | NY
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Zip | 14850
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Country | US
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Telephone | 607-272-0444
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Fax | 607-272-7710
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Provider Business Mailing Address
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Address Line | 179 GRAHAM ROAD SUITE F
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City | ITHACA
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State | NY
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Zip | 14850
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Country | US
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Telephone | 607-272-0444
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Fax | 607-272-7710
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TERESA LEE NIX
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Credential |
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Telephone | 607-272-0444
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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 | 2080L001
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License Number State | NY
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