Provider Demographics
NPI:1902682958
Name:COMFORTING MOMENTS HOME CARE LLC
Entity type:Organization
Organization Name:COMFORTING MOMENTS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCREARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-299-8549
Mailing Address - Street 1:5576 CAMBRIDGE BAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-6117
Mailing Address - Country:US
Mailing Address - Phone:704-299-8549
Mailing Address - Fax:
Practice Address - Street 1:725 CHERRY RD STE 102
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3150
Practice Address - Country:US
Practice Address - Phone:704-299-8549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services