Provider Demographics
NPI:1962870246
Name:FOREVER COMFORTABLE
Entity type:Organization
Organization Name:FOREVER COMFORTABLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:POLES
Authorized Official - Suffix:
Authorized Official - Credentials:BSHS-HEALTHCARE MGMT
Authorized Official - Phone:610-209-9661
Mailing Address - Street 1:PO BOX 24468
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-0168
Mailing Address - Country:US
Mailing Address - Phone:610-314-0960
Mailing Address - Fax:610-314-0960
Practice Address - Street 1:5504 WESTFORD RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2642
Practice Address - Country:US
Practice Address - Phone:610-314-0960
Practice Address - Fax:610-314-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility