Provider Demographics
NPI:1962967661
Name:COMFORT LIFE HOME CARE LLC
Entity type:Organization
Organization Name:COMFORT LIFE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANGUIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-330-0600
Mailing Address - Street 1:4803 ALANZO AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-9227
Mailing Address - Country:US
Mailing Address - Phone:956-330-0600
Mailing Address - Fax:
Practice Address - Street 1:711 W NOLANA AVE STE 201C
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3079
Practice Address - Country:US
Practice Address - Phone:956-330-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care