Provider Demographics
NPI:1134285018
Name:COMPREHENSIVE THERAPEUTIC PROGRAMS #2
Entity Type:Organization
Organization Name:COMPREHENSIVE THERAPEUTIC PROGRAMS #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:BA
Authorized Official - Phone:910-439-4398
Mailing Address - Street 1:1005 BENJAMIN PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7715
Mailing Address - Country:US
Mailing Address - Phone:910-439-4398
Mailing Address - Fax:910-439-5540
Practice Address - Street 1:1005 BENJAMIN PKWY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7715
Practice Address - Country:US
Practice Address - Phone:910-439-4398
Practice Address - Fax:910-439-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities