Provider Demographics
NPI:1447695986
Name:KOMFORT KEEPERS RESIDENTIAL HOME
Entity type:Organization
Organization Name:KOMFORT KEEPERS RESIDENTIAL HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-754-2477
Mailing Address - Street 1:11569 S HIGHWAY 6
Mailing Address - Street 2:PMB # 114
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4932
Mailing Address - Country:US
Mailing Address - Phone:832-754-2477
Mailing Address - Fax:
Practice Address - Street 1:7406 RIPTIDE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2360
Practice Address - Country:US
Practice Address - Phone:832-754-2477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities