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Organization
COMFORT ZONE PERSONAL CARE HOME LLC
Active
Organization
COMFORT ZONE PERSONAL CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET WAIRIMU CLUKEY LPN (DIRECTOR)
(770) 712-9308
Entity
Organization
Contact information
Practice address
485 FROG RD, LOCUST GROVE, GA 30248-3505
(678) 610-5498
(678) 610-5498
Mailing address
301 STONE RD, MCDONOUGH, GA 30253-7267
(770) 712-9308
(678) 610-5498
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
CLA001137
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181993856A
—
GA
Enumeration date
09/13/2012
Last updated
09/13/2012
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