Provider Demographics
NPI:1992526560
Name:COMRADE HOME CARE LLC
Entity type:Organization
Organization Name:COMRADE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:NYAMBURA
Authorized Official - Last Name:OKEMWA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:817-448-2638
Mailing Address - Street 1:907 HEMS LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5922
Mailing Address - Country:US
Mailing Address - Phone:817-448-2638
Mailing Address - Fax:
Practice Address - Street 1:907 HEMS LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5922
Practice Address - Country:US
Practice Address - Phone:817-448-2638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities