Comfort Group Home, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

COMFORT GROUP HOME, LLC

Practice address

13397 Nationville LN
Woodbridge, VA 22193-4152

Phone

(215) 435-7395

NPI assigned

Sep 5, 2019

Organization subpart

No

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

Authorized official

Name

Koretta M Carey

Title

Director

Phone

(215) 435-7395

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1922657618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13397 NATIONVILLE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934152",
            "telephone_number": "215-435-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13397 NATIONVILLE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934152",
            "telephone_number": "215-435-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "KORETTA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-435-7395"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawnita Amber Collins
• Hector M Colon, MD
• Morgan Colon, LMSW
• Brianna Colston
• Shawn Christian Combs, CSA
• Comfort H Dental LLC (Woodbridge Family Dental)
• Commonwealth Audiology LLC
• Commonwealth Ear, Nose & Throat Associates, LLC
• Commonwealth Internal Medicine LLC
• Commonwealth of Virginia State Board of Health (Prince William Health District)

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.