Provider Demographics
NPI:1679107833
Name:SENIOR COMFORT LLC
Entity type:Organization
Organization Name:SENIOR COMFORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAVCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-553-5806
Mailing Address - Street 1:3 PARAGON WAY STE 150
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9581
Mailing Address - Country:US
Mailing Address - Phone:732-984-6380
Mailing Address - Fax:732-984-6424
Practice Address - Street 1:3 PARAGON WAY STE 150
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9581
Practice Address - Country:US
Practice Address - Phone:732-984-6380
Practice Address - Fax:732-984-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home