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General NPI Number Information
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NPI Number | 1487208112
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Entity Type | Organization
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Legal Business Name | COMFORT LIFE CARE ADULT MEDICAL DAY CARE
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 11221 DOLFIELD BLVD STE 100-101
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3254
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Country | US
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Telephone | 443-449-1586
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Fax |
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Provider Business Mailing Address
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Address Line | 11221 DOLFIELD BLVD STE 100-101
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3254
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Country | US
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Telephone | 443-449-1586
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JASWANT DHALIWAL
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Credential |
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Telephone | 443-449-1586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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