Healthcare Provider Details

I. General information

NPI: 1497977649
Provider Name (Legal Business Name): COMPREHENSIVE CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3944 E MAIN ST
WHITEHALL OH
43213-2949
US

IV. Provider business mailing address

6040 E MAIN ST #502
MESA AZ
85205-8928
US

V. Phone/Fax

Practice location:
  • Phone: 614-258-7588
  • Fax:
Mailing address:
  • Phone: 480-396-8355
  • Fax: 480-396-3184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATTI DENNIS
Title or Position: OFFICER
Credential:
Phone: 480-396-8355