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General NPI Number Information
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NPI Number | 1538978127
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Entity Type | Organization
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Legal Business Name | COMFORT GROUP HOME LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 96 N TELEGRAPH RD
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City | PONTIAC
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State | MI
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Zip | 48341-1167
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Country | US
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Telephone | 734-444-7484
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Fax |
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Provider Business Mailing Address
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Address Line | 96 N TELEGRAPH RD
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City | PONTIAC
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State | MI
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Zip | 48341-1167
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Country | US
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Telephone | 734-444-7484
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Fax |
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Authorized Official
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Title or Position | CEO/MANAGER
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Name | SILAS FON TAYONG
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Credential | MD
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Telephone | 734-444-7484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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