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General NPI Number Information
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NPI Number | 1902602444
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Entity Type | Organization
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Legal Business Name | THE VILLAGE COMFORT CARE, LLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1104 POPLAR LN APT 102
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-990-0203
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 POPLAR LN APT 102
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City | EAST LANSING
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State | MI
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Zip | 48823-2543
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Country | US
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Telephone | 313-268-3751
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RUTH MARIAM ABDULLAH
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Credential |
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Telephone | 313-268-3751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 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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