Provider Demographics
NPI:1114458189
Name:COMPREHENSIVE COMMUNITY CONSULTING
Entity Type:Organization
Organization Name:COMPREHENSIVE COMMUNITY CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW
Authorized Official - Phone:347-869-4897
Mailing Address - Street 1:2451 BOLTON LN
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1671
Mailing Address - Country:US
Mailing Address - Phone:410-384-6579
Mailing Address - Fax:
Practice Address - Street 1:2451 BOLTON LN
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1671
Practice Address - Country:US
Practice Address - Phone:410-384-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22118251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management