Provider Demographics
NPI:1437494796
Name:BUDA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:BUDA HEALTH SERVICES, INC.
Other - Org Name:COMFORCARE - LAKE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-960-3419
Mailing Address - Street 1:1117 S MILWAUKEE AVE
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3798
Mailing Address - Country:US
Mailing Address - Phone:847-416-6123
Mailing Address - Fax:
Practice Address - Street 1:1117 S MILWAUKEE AVE
Practice Address - Street 2:SUITE B-3
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3798
Practice Address - Country:US
Practice Address - Phone:847-416-6123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3000984OtherIL STATE LICENSE