MEDICARE: QUALITY COMFORT LIVING & SERVICES 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
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1679202667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY COMFORT LIVING & SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 36302
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44735-6302
Country	:	US
Telephone Number	:	330-280-7659
Fax Number	:

Provider Business Practice Location Address
First Line	:	4117 WHIPPLE AVE NW STE C
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-4800
Country	:	US
Telephone Number	:	330-280-7659
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAREEM DAVISON
Credential	:
Telephone Number	:	330-280-7659

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	06/07/2022

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