{
"Npi": {
"NPI": "1114430907",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMPREHENSIVE ADDICTION TREATMENT LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1950 TOWER HILL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH KINGSTOWN",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02852-6639",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-559-3954",
"MailingAddressFaxNumber": "401-295-2513",
"FirstLinePracticeLocationAddress": "1950 TOWER HILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "N KINGSTOWN",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02852-6639",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-559-3954",
"PracticeLocationAddressFaxNumber": "401-615-8503",
"EnumerationDate": "11/15/2017",
"LastUpdateDate": "11/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COBURN",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER/SOLE PROPRIETOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "401-559-3954",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084A0401X",
"TaxonomyName": "Addiction Medicine (Psychiatry & Neurology) Physician",
"LicenseNumber": "MD08308",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}