Comfort Zone Personal Care Home LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

License

CLA001137 Issued in GA

Legal business name

COMFORT ZONE PERSONAL CARE HOME LLC

Practice address

485 Frog Rd
Locust Grove, GA 30248-3505

Phone

(678) 610-5498

Fax

(678) 610-5498

NPI assigned

Sep 13, 2012

Last updated

Sep 13, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Margaret Wairimu Clukey, LPN

Title

Director

Phone

(770) 712-9308

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1730439159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 STONE RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537267",
            "telephone_number": "770-712-9308",
            "fax_number": "678-610-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 FROG RD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483505",
            "telephone_number": "678-610-5498",
            "fax_number": "678-610-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT ZONE PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "CLUKEY",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "WAIRIMU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-712-9308",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "GA",
            "license": "CLA001137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181993856A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makayla A Carson, DNP, FNP-C
• Cliford Charles
• Roshonda R Chatman
• Aisha Cherry
• Comforcare Clayton Henry LLC (ComForCare Home Care Clayton Henry)
• Beverly O Coogler, RPH
• Wyman Cook Jr.
• Destiny Corbett, DMD
• Correctmed Locust Grove, LLC
• Correctmed Scott, LLC

• Child Intellectual and/or Developmental Disabilities Respite Care in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.