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General NPI Number Information
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NPI Number | 1609101914
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Entity Type | Organization
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Legal Business Name | GOFORTH SERVICES DBA COMFORT KEEPERS
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 901 H ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5125
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Country | US
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Telephone | 530-749-8800
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Fax | 530-741-1446
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Provider Business Mailing Address
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Address Line | 901 H ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5125
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Country | US
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Telephone | 530-749-8800
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Fax | 530-741-1446
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NEIL C GOFORTH
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Credential |
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Telephone | 530-749-8800
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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 | 003131
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License Number State | CA
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