Healthcare Provider Details

I. General information

NPI: 1922925999
Provider Name (Legal Business Name): COMFORT THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 ENERGY LN # 102
SAINT PAUL MN
55108-5273
US

IV. Provider business mailing address

1380 ENERGY LN # 102
SAINT PAUL MN
55108-5273
US

V. Phone/Fax

Practice location:
  • Phone: 952-303-5803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMAL MOHUMED
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 952-303-5803