Provider Demographics
NPI:1215433859
Name:COMFORT LIVING HOME CARE LLC
Entity type:Organization
Organization Name:COMFORT LIVING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATJON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-401-5620
Mailing Address - Street 1:8400 BUSTLETON AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1918
Mailing Address - Country:US
Mailing Address - Phone:267-538-6469
Mailing Address - Fax:267-538-6478
Practice Address - Street 1:8400 BUSTLETON AVE STE 5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1918
Practice Address - Country:US
Practice Address - Phone:267-538-6469
Practice Address - Fax:267-538-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care