Organization
COMFORT KEEPERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM VERCRUYSSEN (OWNER)
(208) 765-9511
Entity
Organization
Contact information
Practice address
820 E BEST AVE, COEUR D ALENE, ID 83814-4836
(208) 765-9511
(208) 765-8710
Mailing address
820 E BEST AVE, COEUR D ALENE, ID 83814-4836
(208) 765-9511
(208) 765-8710
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8057413
—
ID
05
—
M8057414
—
ID
05
—
M8057639
—
ID
Enumeration date
11/18/2014
Last updated
11/18/2014
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