Healthcare Provider Details

I. General information

NPI: 1679984397
Provider Name (Legal Business Name): A1 COMFORT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 E WERGES AVE
INDIANAPOLIS IN
46237-1063
US

IV. Provider business mailing address

2310 E WERGES AVE
INDIANAPOLIS IN
46237-1063
US

V. Phone/Fax

Practice location:
  • Phone: 317-783-5040
  • Fax: 317-783-5040
Mailing address:
  • Phone: 317-783-5040
  • Fax: 317-783-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MUKI NDABAMBI
Title or Position: MANAGING PARTNER
Credential:
Phone: 317-557-5154