Provider Demographics
NPI:1558134411
Name:COMFORT BEHAVIORAL HEALTH CARE LLC
Entity Type:Organization
Organization Name:COMFORT BEHAVIORAL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEDOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIMOLOWO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:347-912-7566
Mailing Address - Street 1:647 STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1822
Mailing Address - Country:US
Mailing Address - Phone:908-370-7546
Mailing Address - Fax:
Practice Address - Street 1:647 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1822
Practice Address - Country:US
Practice Address - Phone:908-370-7546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty