Provider Demographics
NPI:1619605987
Name:COMFORT BEHAVIOR CENTRE INC
Entity Type:Organization
Organization Name:COMFORT BEHAVIOR CENTRE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-986-4834
Mailing Address - Street 1:1710 DOUGLAS DR N STE 224S
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 DOUGLAS DR N STE 224S
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4361
Practice Address - Country:US
Practice Address - Phone:612-986-4834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency