=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912302944
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMFORT LIVING SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2014
-----------------------------------------------------
Last Update Date | 11/04/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8860 COLUMBIA 100 PKWY SUITE #304
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21045-2195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-319-8990
-----------------------------------------------------
Fax | 443-315-4021
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8860 COLUMBIA 100 PKWY SUITE #304
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21045-2195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-319-8990
-----------------------------------------------------
Fax | 443-315-4021
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF CLINICAL SERVICES
-----------------------------------------------------
Name | HANNAH KAMAU
-----------------------------------------------------
Credential | RN, BSN
-----------------------------------------------------
Telephone | 443-319-8990
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------