Healthcare Provider Details

I. General information

NPI: 1700883790
Provider Name (Legal Business Name): COMPREHENSIVE CARE, INC..
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 HIGH ST SUITE 205
WASHINGTON MO
63090-6447
US

IV. Provider business mailing address

1451 HIGH ST SUITE 203
WASHINGTON MO
63090-6447
US

V. Phone/Fax

Practice location:
  • Phone: 636-390-9909
  • Fax: 636-390-8992
Mailing address:
  • Phone: 636-390-9510
  • Fax: 636-390-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00010647
License Number StateMO

VIII. Authorized Official

Name: MARY CRANMER
Title or Position: PRESIDENT
Credential:
Phone: 636-390-9909