Provider Demographics
NPI:1174519979
Name:COMFORT CARE OF HOLY SPIRIT INC
Entity type:Organization
Organization Name:COMFORT CARE OF HOLY SPIRIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BUSINESS OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-4697
Mailing Address - Street 1:205 GRANDVIEW CORPORATE PLACE
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-972-4663
Mailing Address - Fax:
Practice Address - Street 1:205 GRANDVIEW CORPORATE PLACE
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:717-972-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA725005251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1111096Medicaid
PA397250BMedicare ID - Type UnspecifiedHOME HEALTH PROVIDER NUMB