MEDICARE: COMFORT CARE ATLANTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1457107054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT CARE ATLANTIC LLC

Provider Business Mailing Address
First Line	:	3503 TALL SYCAMORE TRL
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3065
Country	:	US
Telephone Number	:	202-813-6456
Fax Number	:

Provider Business Practice Location Address
First Line	:	3503 TALL SYCAMORE TRL
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3065
Country	:	US
Telephone Number	:	202-813-6456
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VALERY AYUK
Credential	:
Telephone Number	:	202-813-6456

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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