Provider Demographics
NPI:1073801767
Name:COMPREHENSIVE OUTPATIENT SERVICES INC
Entity Type:Organization
Organization Name:COMPREHENSIVE OUTPATIENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSOY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-527-4610
Mailing Address - Street 1:3833 NOBEL DR
Mailing Address - Street 2:APT 3104
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5702
Mailing Address - Country:US
Mailing Address - Phone:845-570-1278
Mailing Address - Fax:
Practice Address - Street 1:2 COURTHOUSE LN
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1715
Practice Address - Country:US
Practice Address - Phone:617-527-4610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health