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General NPI Number Information
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NPI Number | 1093711459
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE COUNSELING CENTER PC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 11885 E 12 MILE RD STE. 201A
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City | WARREN
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State | MI
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Zip | 48093-3474
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Country | US
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Telephone | 586-558-6000
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Fax | 586-558-6679
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Provider Business Mailing Address
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Address Line | 11885 E 12 MILE RD STE. 201A
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City | WARREN
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State | MI
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Zip | 48093-3474
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Country | US
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Telephone | 586-558-6000
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Fax | 586-558-6679
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | SUDHIR V LINGNURKAR MD
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Credential | MD
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Telephone | 586-558-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0000000000
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License Number State | MI
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