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General NPI Number Information
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NPI Number | 1912214180
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Entity Type | Organization
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Legal Business Name | THE COMFORTS OF HOME ADULT DAY HEALTH CARE, LLC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 2701 MANHATTAN BLVD STE 14
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City | HARVEY
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State | LA
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Zip | 70058-6149
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Country | US
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Telephone | 504-367-0889
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Fax | 504-367-0152
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Provider Business Mailing Address
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Address Line | 2701 MANHATTAN BLVD STE 14
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City | HARVEY
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State | LA
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Zip | 70058-6149
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Country | US
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Telephone | 504-367-0889
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Fax | 504-367-0152
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHONITRA ADONICA VAUGHN
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Credential | RN
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Telephone | 504-367-0889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 5059
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License Number State | LA
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