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NPI 1821804303

NPI 1821804303 : MR. SAMUEL COMFORT : OMAHA, NE

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General NPI Number Information
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    NPI Number           |    1821804303
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    Entity Type          |    Individual 
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    Provider Name        |    MR. SAMUEL COMFORT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/09/2024
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    Last Update Date     |    05/14/2025
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Provider Practice Location Address
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    Address Line         |    15677 SPAULDING ST 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68116-8411
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    Country              |    US
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    Telephone            |    402-614-8202
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    Fax                  |    402-403-4981
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Provider Business Mailing Address
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    Address Line         |    15677 SPAULDING ST 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68116-8411
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    Country              |    US
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    Telephone            |    402-614-8202
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    Fax                  |    402-403-4981
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    373H00000X
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    Taxonomy Name        |    Day Training/Habilitation Specialist
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    License Number       |    
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    License Number State |    
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