Provider Demographics
NPI:1215423827
Name:COMFORTABLE LIVING LLC
Entity type:Organization
Organization Name:COMFORTABLE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:L
Authorized Official - Last Name:FORD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:859-300-9760
Mailing Address - Street 1:415 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1829
Mailing Address - Country:US
Mailing Address - Phone:859-300-9760
Mailing Address - Fax:
Practice Address - Street 1:870 CORPORATE DR STE 104
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5417
Practice Address - Country:US
Practice Address - Phone:859-300-9760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1255059101Medicaid