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General NPI Number Information
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NPI Number | 1639468127
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 104 JAVIT CT
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City | AUSTINTOWN
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State | OH
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Zip | 44515-2439
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Country | US
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Telephone | 330-797-4050
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Fax | 330-797-4090
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Provider Business Mailing Address
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Address Line | 104 JAVIT CT
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City | AUSTINTOWN
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State | OH
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Zip | 44515-2439
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Country | US
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Telephone | 330-797-4050
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Fax | 330-797-4090
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SASI KAZA
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Credential |
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Telephone | 330-797-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 35042814
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License Number State | OH
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