Provider Demographics
NPI:1376083139
Name:COMFORT MENTAL CENTER LLC
Entity Type:Organization
Organization Name:COMFORT MENTAL CENTER LLC
Other - Org Name:COMFORT MENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDINASIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-886-9481
Mailing Address - Street 1:2121 NICOLLET AVE
Mailing Address - Street 2:SUIT 6
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2566
Mailing Address - Country:US
Mailing Address - Phone:612-886-9481
Mailing Address - Fax:
Practice Address - Street 1:2121 NICOLLET AVE
Practice Address - Street 2:SUIT 6
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2566
Practice Address - Country:US
Practice Address - Phone:612-886-9481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health