Healthcare Provider Details

I. General information

NPI: 1336682160
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 BARDSTOWN RD
LOUISVILLE KY
40218-4001
US

IV. Provider business mailing address

PO BOX 2825
CARBONDALE IL
62902-2825
US

V. Phone/Fax

Practice location:
  • Phone: 502-491-0941
  • Fax:
Mailing address:
  • Phone: 618-529-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: PAULA HUTCHERSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 813-626-1444