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General NPI Number Information
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NPI Number | 1982030086
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Entity Type | Organization
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Legal Business Name | AT HOME COMFORT
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 10081B KINGS HWY
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City | KING GEORGE
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State | VA
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Zip | 22485-3445
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Country | US
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Telephone | 540-625-2015
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Fax | 540-625-2016
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Provider Business Mailing Address
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Address Line | 10081B KINGS HWY
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City | KING GEORGE
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State | VA
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Zip | 22485-3445
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Country | US
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Telephone | 540-625-2015
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Fax | 540-625-2016
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MRS. GLENDA RAE KULYNYCH
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Credential |
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Telephone | 540-625-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | HCO-14998
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License Number State | VA
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