Healthcare Provider Details

I. General information

NPI: 1932926482
Provider Name (Legal Business Name): COMFORT HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 EGAN DR STE 100
SAVAGE MN
55378-2299
US

IV. Provider business mailing address

7447 EGAN DR STE 100
SAVAGE MN
55378-2299
US

V. Phone/Fax

Practice location:
  • Phone: 651-210-1561
  • Fax:
Mailing address:
  • Phone: 651-210-1561
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ONWONA-APPIAH
Title or Position: PROGRAM DIRECTOR
Credential: RN
Phone: 612-298-4872