Provider Demographics
NPI:1740606805
Name:COMG HOME HEALTHCARE INC
Entity type:Organization
Organization Name:COMG HOME HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:GBOLABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-331-8130
Mailing Address - Street 1:8500 N STEMMONS FWY STE 3067
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3832
Mailing Address - Country:US
Mailing Address - Phone:972-331-8130
Mailing Address - Fax:972-331-8131
Practice Address - Street 1:8500 N STEMMONS FWY STE 3067
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3832
Practice Address - Country:US
Practice Address - Phone:972-331-8130
Practice Address - Fax:972-331-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health