Provider Demographics
NPI:1053010462
Name:RESIDENTIAL COMFORT CARE LLC
Entity type:Organization
Organization Name:RESIDENTIAL COMFORT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEE BERNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIFWANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-469-9188
Mailing Address - Street 1:4017 POSTGATE TER APT 203
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6013
Mailing Address - Country:US
Mailing Address - Phone:202-469-9188
Mailing Address - Fax:
Practice Address - Street 1:4017 POSTGATE TER APT 203
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-6013
Practice Address - Country:US
Practice Address - Phone:202-469-9188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities