Healthcare Provider Details

I. General information

NPI: 1265841738
Provider Name (Legal Business Name): COMPREHENSIVE COMMUNITY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 08/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 WINDCREST DR
APEX NC
27502-1374
US

IV. Provider business mailing address

3308 DURHAM CHAPEL HILL BLVD. BUILDING F
DURHAM NC
27707-6200
US

V. Phone/Fax

Practice location:
  • Phone: 919-489-4202
  • Fax:
Mailing address:
  • Phone: 919-402-0323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CAROLYN BATTS-GOWINS
Title or Position: DIRECTOR OF QUALITY ASSURANCE
Credential: QP
Phone: 919-489-4202