Provider Demographics
NPI:1184415358
Name:COMFORTCARE HOMES 29TH/TYLER
Entity type:Organization
Organization Name:COMFORTCARE HOMES 29TH/TYLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-685-3322
Mailing Address - Street 1:245 N WACO ST STE 220
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1102
Mailing Address - Country:US
Mailing Address - Phone:316-685-3322
Mailing Address - Fax:
Practice Address - Street 1:8631 W 29TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-9403
Practice Address - Country:US
Practice Address - Phone:316-685-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORTCARE HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)