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General NPI Number Information
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NPI Number | 1962894162
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Entity Type | Organization
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Legal Business Name | COMFORT CARE HOME CARE & COMPANION SERVICES
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 1517 KEATS RD
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City | JACKSONVILLE
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State | FL
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Zip | 32208-3119
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Country | US
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Telephone | 904-486-6189
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9727
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City | JACKSONVILLE
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State | FL
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Zip | 32208-0727
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Country | US
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Telephone | 904-486-6189
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LASHAWNDA NORRIS
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Credential |
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Telephone | 904-486-6189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233688
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License Number State | FL
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