Healthcare Provider Details

I. General information

NPI: 1659764249
Provider Name (Legal Business Name): COMPREHENSIVE MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 TOWN CENTRE DR STE 300
BROADVIEW HTS OH
44147-4048
US

IV. Provider business mailing address

7500 TOWN CENTRE DR STE 300
BROADVIEW HTS OH
44147-4048
US

V. Phone/Fax

Practice location:
  • Phone: 440-554-0035
  • Fax: 440-596-1178
Mailing address:
  • Phone: 440-554-0035
  • Fax: 440-596-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35-125659
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SONIA PRAFUL DESAI
Title or Position: PHYSICIAN
Credential: MD
Phone: 440-554-0035