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General NPI Number Information
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NPI Number | 1104780410
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Entity Type | Organization
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Legal Business Name | J&K COMFORT HOME
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 107 3RD AVE SW
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City | ISANTI
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State | MN
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Zip | 55040-7496
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Country | US
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Telephone | 763-452-0248
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Fax | 763-452-0206
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Provider Business Mailing Address
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Address Line | 107 3RD AVE SW
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City | ISANTI
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State | MN
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Zip | 55040-7496
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Country | US
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Telephone | 763-452-0248
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Fax | 763-452-0206
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Authorized Official
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Title or Position | MANAGER
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Name | KEVIN NYABICHA
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Credential |
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Telephone | 612-735-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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