Provider Demographics
NPI:1811716285
Name:VAIL COMFORT HOMECARE LLC
Entity type:Organization
Organization Name:VAIL COMFORT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:NDAYAMBAJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-914-1989
Mailing Address - Street 1:8211 PURPLE ASTER PASS
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-2295
Mailing Address - Country:US
Mailing Address - Phone:512-595-9334
Mailing Address - Fax:
Practice Address - Street 1:8211 PURPLE ASTER PASS
Practice Address - Street 2:
Practice Address - City:LAGO VISTA
Practice Address - State:TX
Practice Address - Zip Code:78645-2295
Practice Address - Country:US
Practice Address - Phone:512-595-9334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care