Organization
AT HOME COMFORT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLETTE WALKER (LPN SOLE MEMBER)
(216) 235-2429
Entity
Organization
Contact information
Practice address
1042 ANSEL RD, CLEVELAND, OH 44103-2268
(216) 235-2429
(216) 235-2429
Mailing address
1042 ANSEL RD, CLEVELAND, OH 44103-2268
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548627987
—
OH
Enumeration date
01/23/2018
Last updated
01/23/2018
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