Healthcare Provider Details

I. General information

NPI: 1639225600
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SUSAN ROAD
S. EASTON MA
02375-1608
US

IV. Provider business mailing address

639 GRANITE STREET SUITE 215
BRAINTREE MA
02184
US

V. Phone/Fax

Practice location:
  • Phone: 508-238-3496
  • Fax: 508-238-3578
Mailing address:
  • Phone: 781-356-6330
  • Fax: 781-356-6334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SCOTT DAVIS
Title or Position: SR. BUSINESS DIRECTOR
Credential:
Phone: 618-529-3060