Provider Demographics
NPI:1144383464
Name:COMPREHENSIVE SYSTEMS, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE SYSTEMS, INC
Other - Org Name:MASON CITY GROUP HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-228-4842
Mailing Address - Street 1:1700 CLARK ST
Mailing Address - Street 2:PO BOX 457
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616-0457
Mailing Address - Country:US
Mailing Address - Phone:641-228-4842
Mailing Address - Fax:641-228-4675
Practice Address - Street 1:695 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5405
Practice Address - Country:US
Practice Address - Phone:641-228-4842
Practice Address - Fax:641-228-4675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA170064311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0893339Medicaid