Provider Demographics
NPI:1124185996
Name:COMFORT HOME HEALTHCARE
Entity type:Organization
Organization Name:COMFORT HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:I
Authorized Official - Last Name:ALIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:704-371-5009
Mailing Address - Street 1:4919 ALBEMARLE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6683
Mailing Address - Country:US
Mailing Address - Phone:704-537-0870
Mailing Address - Fax:704-537-0807
Practice Address - Street 1:4919 ALBEMARLE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6683
Practice Address - Country:US
Practice Address - Phone:704-537-0870
Practice Address - Fax:704-537-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3326251E00000X
NCHC3692251E00000X
NCHC2263251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409539Medicaid
NC7100554Medicaid
NC6600890Medicaid
NC6800479Medicaid