Healthcare Provider Details

I. General information

NPI: 1770115479
Provider Name (Legal Business Name): COMPREHENSIVE HEALTHCARE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 NICOLLET AVE STE 211
MINNEAPOLIS MN
55408-1628
US

IV. Provider business mailing address

2614 NICOLLET AVE
MINNEAPOLIS MN
55408-1628
US

V. Phone/Fax

Practice location:
  • Phone: 952-217-6575
  • Fax:
Mailing address:
  • Phone: 952-217-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ISMAIL J MOHAMED
Title or Position: CEO/DURECTOR
Credential: RT
Phone: 952-217-6575