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General NPI Number Information
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NPI Number | 1760916647
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Entity Type | Organization
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Legal Business Name | AMAZING COMFORT HOME LLC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 1670 E CARLA VISTA DR
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City | CHANDLER
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State | AZ
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Zip | 85225-5268
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Country | US
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Telephone | 480-207-1510
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Fax | 480-207-1510
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Provider Business Mailing Address
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Address Line | 1670 E CARLA VISTA DR
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City | CHANDLER
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State | AZ
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Zip | 85225-5268
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Country | US
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Telephone | 480-207-1510
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Fax | 480-207-1510
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LORETA JONES
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Credential |
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Telephone | 480-207-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | AL10289H
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License Number State | AZ
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