Organization
COMFORTER CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILUS EBOSI MBA HEALTHCARE MAGT. (CEO)
(517) 974-9012
Entity
Organization
Contact information
Practice address
4830 MALPASO, LANSING, MI 48917-1554
(517) 974-9012
(517) 886-5194
Mailing address
4830 MALPASO, LANSING, MI 48917-1554
(517) 974-9012
(517) 886-5194
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MSA
—
MI
Enumeration date
09/10/2011
Last updated
09/10/2011
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