Provider Demographics
NPI:1528069523
Name:COMFORT CARE HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:COMFORT CARE HOME HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VILLALVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:303-399-7797
Mailing Address - Street 1:19751 EAST MAINSTREET
Mailing Address - Street 2:SUITE 333
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138
Mailing Address - Country:US
Mailing Address - Phone:303-399-7797
Mailing Address - Fax:303-399-7793
Practice Address - Street 1:19751 EAST MAINSTREET
Practice Address - Street 2:SUITE 333
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138
Practice Address - Country:US
Practice Address - Phone:303-399-7797
Practice Address - Fax:303-399-7793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0404F5251F00000X, 251E00000X
343900000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05701917Medicaid
CO067294Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER
067294Medicare Oscar/Certification