Provider Demographics
NPI:1083843973
Name:COMFORCARE
Entity type:Organization
Organization Name:COMFORCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEMIO
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-241-1102
Mailing Address - Street 1:837 N GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2128
Mailing Address - Country:US
Mailing Address - Phone:818-241-1102
Mailing Address - Fax:818-241-1243
Practice Address - Street 1:837 N GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-2128
Practice Address - Country:US
Practice Address - Phone:818-241-1102
Practice Address - Fax:818-241-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service