Provider Demographics
NPI:1588337109
Name:COMMMERCE COMFORT CARE
Entity type:Organization
Organization Name:COMMMERCE COMFORT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT CARE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:248-896-1400
Mailing Address - Street 1:100 DECKER RD
Mailing Address - Street 2:
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3625
Mailing Address - Country:US
Mailing Address - Phone:248-896-1400
Mailing Address - Fax:248-859-5214
Practice Address - Street 1:100 DECKER RD
Practice Address - Street 2:
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3625
Practice Address - Country:US
Practice Address - Phone:248-896-1400
Practice Address - Fax:248-859-5214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home