Provider Demographics
NPI:1689814519
Name:MADNIK, INC
Entity Type:Organization
Organization Name:MADNIK, INC
Other - Org Name:COMFORT KEEPERS 416/191
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:PUSATERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-716-8832
Mailing Address - Street 1:26381 CROWN VALLEY PKWY
Mailing Address - Street 2:231-C
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6368
Mailing Address - Country:US
Mailing Address - Phone:949-716-8832
Mailing Address - Fax:949-716-8832
Practice Address - Street 1:26381 CROWN VALLEY PKWY
Practice Address - Street 2:231-C
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6368
Practice Address - Country:US
Practice Address - Phone:949-716-8832
Practice Address - Fax:949-716-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care