Healthcare Provider Details

I. General information

NPI: 1912487976
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W MILL ST
CARBONDALE IL
62901-2727
US

IV. Provider business mailing address

6600 FRANCE AVE S STE 350
EDINA MN
55435-1810
US

V. Phone/Fax

Practice location:
  • Phone: 618-319-4883
  • Fax:
Mailing address:
  • Phone: 800-388-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number4000021
License Number StateIL

VIII. Authorized Official

Name: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: CHIEF REGULATORY OFFICER SR ASST GC
Credential:
Phone: 952-836-2234