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Organization

COMFORT SUPPORT HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWAN MBAKU (DIRECTOR)
(240) 441-3944
Entity
Organization

Contact information

Practice address
3157 HOLLOWAY RD, FALLS CHURCH, VA 22042-4205
(240) 441-3944
Mailing address
3157 HOLLOWAY RD, FALLS CHURCH, VA 22042-4205
(240) 441-3944

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
07/26/2019
Last updated
07/26/2019
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