Avid Comfort Homecare

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AVID COMFORT HOMECARE

Practice address

2144 175TH St
Lansing, IL 60438-1620

Phone

(222) 245-7288

NPI assigned

Nov 9, 2023

Organization subpart

No

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

Authorized official

Name

Marcus Millison

Title

Owner

Phone

(707) 083-5102

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1972377992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BLACKSTONE ST",
            "city": "THORNTON",
            "state": "IL",
            "postal_code": "604761079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 175TH ST",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604381620",
            "telephone_number": "222-245-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVID COMFORT HOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "MILLISON",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-083-5102"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.