Healthcare Provider Details

I. General information

NPI: 1003961129
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 CLEMENT ROAD
LUTZ FL
33549-5552
US

IV. Provider business mailing address

980 WASHINGTON ST STE 306
DEDHAM MA
02026-6797
US

V. Phone/Fax

Practice location:
  • Phone: 813-948-3325
  • Fax: 813-948-6560
Mailing address:
  • Phone: 781-708-9444
  • Fax: 813-621-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: SERGIO P CRUZ
Title or Position: CFO
Credential:
Phone: 781-708-9444