Healthcare Provider Details

I. General information

NPI: 1114985413
Provider Name (Legal Business Name): COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 JAVIT CT
YOUNGSTOWN OH
44515-2439
US

IV. Provider business mailing address

104 JAVIT CT
YOUNGSTOWN OH
44515-2409
US

V. Phone/Fax

Practice location:
  • Phone: 330-797-4050
  • Fax: 330-797-4090
Mailing address:
  • Phone: 330-797-4050
  • Fax: 330-797-4090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. SASI KAZA
Title or Position: CEO
Credential:
Phone: 330-990-0960