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General NPI Number Information
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NPI Number | 1225295819
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CARE CENTER, INC.
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 1231 N TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34237-3116
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Country | US
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Telephone | 941-366-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 1231 N TUTTLE AVE
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City | SARASOTA
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State | FL
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Zip | 34237-3116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FISCAL ASSISTANT
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Name | BOBBI BRADLEY
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Credential |
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Telephone | 941-366-0134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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