Provider Demographics
NPI:1841593142
Name:COMFORT BEHAVIORAL HEALTH SOCIAL SERVICES LLC.
Entity type:Organization
Organization Name:COMFORT BEHAVIORAL HEALTH SOCIAL SERVICES LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FUNMILAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJABI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-492-4739
Mailing Address - Street 1:P.O. BOX 1045
Mailing Address - Street 2:445 E. G. MILES PKWY # SUITE 108
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31310
Mailing Address - Country:US
Mailing Address - Phone:912-368-3622
Mailing Address - Fax:912-368-6820
Practice Address - Street 1:445 E. G. MILES PARKWAY
Practice Address - Street 2:SUITE # 108
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313
Practice Address - Country:US
Practice Address - Phone:912-368-6822
Practice Address - Fax:912-368-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty