Provider Demographics
NPI:1427432442
Name:COMFORT CARE PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:COMFORT CARE PROVIDER SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-293-9631
Mailing Address - Street 1:PO BOX 659
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-0659
Mailing Address - Country:US
Mailing Address - Phone:972-293-9631
Mailing Address - Fax:214-292-8843
Practice Address - Street 1:206 OAK MEADOW LN
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3282
Practice Address - Country:US
Practice Address - Phone:972-293-9631
Practice Address - Fax:214-292-8843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016901253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care