Provider Demographics
NPI:1528648854
Name:COMFORT CPA CARE LLC
Entity type:Organization
Organization Name:COMFORT CPA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:817-808-1318
Mailing Address - Street 1:4309 JENNIFER LN
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-5501
Mailing Address - Country:US
Mailing Address - Phone:817-808-1318
Mailing Address - Fax:
Practice Address - Street 1:2100 N HWY 360 STE 1200
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-8708
Practice Address - Country:US
Practice Address - Phone:817-808-1318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Yes253J00000XAgenciesFoster Care Agency
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679029136Medicaid