Healthcare Provider Details

I. General information

NPI: 1528306404
Provider Name (Legal Business Name): COMPREHENSIVE CONTINGENCY TASK FORCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3649 VICTORY DR
COLUMBUS GA
31903-4553
US

IV. Provider business mailing address

825 N HAMMONDS FERRY RD
LINTHICUM MD
21090-1355
US

V. Phone/Fax

Practice location:
  • Phone: 706-221-5025
  • Fax:
Mailing address:
  • Phone: 443-457-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE TORRES
Title or Position: NURSING SUPERISOR
Credential: LPN
Phone: 706-221-5025