Provider Demographics
NPI:1275358087
Name:COMFORTAIDE
Entity type:Organization
Organization Name:COMFORTAIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-660-4757
Mailing Address - Street 1:2090 BAKER RD
Mailing Address - Street 2:STE 304 #1017
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4617
Mailing Address - Country:US
Mailing Address - Phone:404-947-6004
Mailing Address - Fax:
Practice Address - Street 1:3100 INTERSTATE NORTH CIRCLE SOUTHEAST
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:404-947-6004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITIAL VENTURES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)