MEDICARE: COMFORT PEACE HOME CARE 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	:	1659899060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT PEACE HOME CARE LLC

Provider Business Mailing Address
First Line	:	21305 HIGHLAND DR
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94552-4814
Country	:	US
Telephone Number	:	510-688-3795
Fax Number	:

Provider Business Practice Location Address
First Line	:	21305 HIGHLAND DR
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94552-4814
Country	:	US
Telephone Number	:	510-688-3795
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUEL AINA
Credential	:
Telephone Number	:	510-688-3795

Provider Enumeration Date	:	09/06/2017
Last Update Date	:	07/21/2022

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