# AZ COMFORT HOME, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AZ COMFORT HOME, INC
- **Other names:** Cottonwood House
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811554074
- **Legal business name:** AZ COMFORT HOME, INC
- **Authorized official:** JOHN OMIJIE (PROGRAM DIRECTOR)
- **Authorized official phone:** (623) 326-3327

## Contact information

- **Practice address:** 16439 W COTTONWOOD ST, SURPRISE, AZ 85388-2160
- **Practice address phone:** (623) 666-3895
- **Practice address fax:** (623) 321-1206
- **Mailing address:** 18412 W MISSION LN, WADDELL, AZ 85355-4303
- **Mailing address phone:** (623) 326-3327
- **Mailing address fax:** (623) 321-1206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/23/2019
- **Last updated:** 05/23/2019