Provider Demographics
NPI:1033268859
Name:COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KOTESWARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-797-4050
Mailing Address - Street 1:5305 SYCAMORE HILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-8769
Mailing Address - Country:US
Mailing Address - Phone:330-542-9535
Mailing Address - Fax:
Practice Address - Street 1:104 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2409
Practice Address - Country:US
Practice Address - Phone:330-797-4050
Practice Address - Fax:330-797-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH965575101YA0400X
OHE0002791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty