Healthcare Provider Details

I. General information

NPI: 1750467080
Provider Name (Legal Business Name): COMPREHENSIVE THERAPEUTIC PROGRAMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N SCHOOL ST
MT GILEAD NC
27306
US

IV. Provider business mailing address

PO BOX 1242
MT GILEAD NC
27306
US

V. Phone/Fax

Practice location:
  • Phone: 910-439-4398
  • Fax: 910-439-5540
Mailing address:
  • Phone: 910-439-4398
  • Fax: 910-439-5540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHARLES KEY JR.
Title or Position: PROGRAM MANAGER
Credential: BA
Phone: 910-995-5460