MEDICARE: CENTER FOR COMPREHENSIVE SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283X00000X	Rehabilitation Hospital

General Provider Information

NPI Number	:	1548631914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR COMPREHENSIVE SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 2825
Second Line	:
City	:	CARBONDALE
State	:	IL
Zip	:	62902-2825
Country	:	US
Telephone Number	:	618-529-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 WINDSOR PATH
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-9610
Country	:	US
Telephone Number	:	502-863-3870
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OPERATIONS
Name	:	CHRISTOPHER WILLIAMSON
Credential	:
Telephone Number	:	618-529-3060

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	10/12/2015

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