Healthcare Provider Details

I. General information

NPI: 1164316022
Provider Name (Legal Business Name): COMPREHENSIVE HEALTH AND BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 S CLARK ST STE 638
ARLINGTON VA
22202-4016
US

IV. Provider business mailing address

1401 MERCANTILE LN STE 531
LARGO MD
20774-4326
US

V. Phone/Fax

Practice location:
  • Phone: 410-304-6656
  • Fax: 410-304-6645
Mailing address:
  • Phone: 410-304-6656
  • Fax: 410-304-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: RENATA BEBONGNCHU NKEZE
Title or Position: CEO
Credential:
Phone: 410-304-6656