=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780563304
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COZY HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2025
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11947 SE 254TH ST
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98030-6535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-440-6553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11947 SE 254TH ST
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98030-6535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-440-6553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HOME CARE AGENCY
-----------------------------------------------------
Name | SAHRO DIRIYE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 206-440-6553
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------