Provider Demographics
NPI:1447853130
Name:ECORAH COMFORT HOMECARE SERVICES, LLC
Entity type:Organization
Organization Name:ECORAH COMFORT HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:904-502-0386
Mailing Address - Street 1:6028 CHESTER AVE STE 206D
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217
Mailing Address - Country:US
Mailing Address - Phone:904-502-0386
Mailing Address - Fax:
Practice Address - Street 1:6028 CHESTER AVE STE 206D
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217
Practice Address - Country:US
Practice Address - Phone:904-502-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care