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General NPI Number Information
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NPI Number | 1063723179
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Entity Type | Organization
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Legal Business Name | COMFORT CARE HOME
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 2155 ENGLISH ST
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City | MAPLEWOOD
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State | MN
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Zip | 55109-3428
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Country | US
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Telephone | 952-452-3765
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Fax |
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Provider Business Mailing Address
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Address Line | 2155 ENGLISH ST
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City | MAPLEWOOD
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State | MN
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Zip | 55109-3428
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Country | US
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Telephone | 952-452-3765
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | FARTUUN ABDULLE
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Credential |
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Telephone | 952-452-3765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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