Healthcare Provider Details

I. General information

NPI: 1700160363
Provider Name (Legal Business Name): COMPREHENSIVE CLIENT CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 MAIN ST
AVOCA PA
18641-1623
US

IV. Provider business mailing address

39 S BEECH RD
PLAINS PA
18705-2203
US

V. Phone/Fax

Practice location:
  • Phone: 570-451-3050
  • Fax: 570-451-3055
Mailing address:
  • Phone: 570-451-3050
  • Fax: 570-451-3055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. JANET TROMBETTA
Title or Position: PRESIDENT/CEO
Credential: R.N.
Phone: 570-472-1299