Provider Demographics
NPI:1073971453
Name:COMPREHENSIVE ADDICTION SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE ADDICTION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-835-4545
Mailing Address - Street 1:484 S MILLER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4176
Mailing Address - Country:US
Mailing Address - Phone:330-835-4545
Mailing Address - Fax:
Practice Address - Street 1:2816 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-4264
Practice Address - Country:US
Practice Address - Phone:937-322-8977
Practice Address - Fax:937-322-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty