| Organization Name: | COMFORT COMPANION CHOICE INC |
| NPI Number: | 1013241066 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LA SHON GURROLA (OWNER/ PROGRAM DIRECTOR) |
| Mailing Address: | 818 Harrison St Suite 206 Oak Park |
| State: | IL US |
| Postal Code: | 603041144 |
| Phone Number: | 7083863324 |
| Fax Number: | 7083863397 |
| NPI Enumeration Date: | 09/23/2009 |
| NPI Last Update Date: | 11/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |