Provider Demographics
NPI:1063259422
Name:THE COMFORT PLACE LTD
Entity type:Organization
Organization Name:THE COMFORT PLACE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OMOWUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-570-2025
Mailing Address - Street 1:11905 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3724
Mailing Address - Country:US
Mailing Address - Phone:818-691-3257
Mailing Address - Fax:
Practice Address - Street 1:11905 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3724
Practice Address - Country:US
Practice Address - Phone:818-691-3257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility