Provider Demographics
NPI:1093017162
Name:COMPREHENSIVE MENTAL HEALTH, P.A.
Entity Type:Organization
Organization Name:COMPREHENSIVE MENTAL HEALTH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:OMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:252-414-8202
Mailing Address - Street 1:114 FOREST HILL AVE # 102
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3728
Mailing Address - Country:US
Mailing Address - Phone:252-414-8202
Mailing Address - Fax:252-443-2948
Practice Address - Street 1:114 FOREST HILL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3728
Practice Address - Country:US
Practice Address - Phone:252-414-8202
Practice Address - Fax:252-443-2948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty