Provider Demographics
NPI:1063723179
Name:COMFORT CARE HOME
Entity type:Organization
Organization Name:COMFORT CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FARTUUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-452-3765
Mailing Address - Street 1:2155 ENGLISH ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3428
Mailing Address - Country:US
Mailing Address - Phone:952-452-3765
Mailing Address - Fax:
Practice Address - Street 1:2155 ENGLISH ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-3428
Practice Address - Country:US
Practice Address - Phone:952-452-3765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care