Provider Demographics
NPI:1215424049
Name:COMFORTS OF HOME DIALYSIS, LLC
Entity type:Organization
Organization Name:COMFORTS OF HOME DIALYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:HEBERTO
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:956-627-5911
Mailing Address - Street 1:1616 E GRIFFIN PKWY # 202
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3180
Mailing Address - Country:US
Mailing Address - Phone:956-627-5911
Mailing Address - Fax:956-627-5655
Practice Address - Street 1:1001 MILLER AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4115
Practice Address - Country:US
Practice Address - Phone:956-627-5911
Practice Address - Fax:956-627-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health