Provider Demographics
NPI:1760081046
Name:COMFORT CARE GROUP HOMES LLC
Entity Type:Organization
Organization Name:COMFORT CARE GROUP HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADETUNJI
Authorized Official - Middle Name:THEOPHYLLUS
Authorized Official - Last Name:OJUADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-955-4738
Mailing Address - Street 1:20826 BLUE TRINITY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2296
Mailing Address - Country:US
Mailing Address - Phone:210-955-4738
Mailing Address - Fax:
Practice Address - Street 1:20826 BLUE TRINITY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2296
Practice Address - Country:US
Practice Address - Phone:210-955-4738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care