Provider Demographics
NPI:1588476287
Name:COMFORTAIDE LLC
Entity type:Organization
Organization Name:COMFORTAIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THIANPHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-892-8159
Mailing Address - Street 1:535 VENICE WAY REAR UNIT 1/2
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-4243
Mailing Address - Country:US
Mailing Address - Phone:951-892-8159
Mailing Address - Fax:
Practice Address - Street 1:535 VENICE WAY REAR UNIT 1/2
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-4243
Practice Address - Country:US
Practice Address - Phone:951-892-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty