Provider Demographics
NPI:1255683322
Name:COMPREHENSIVE CARE, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-820-3181
Mailing Address - Street 1:2612 COUNTRY CLUB DR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-4913
Mailing Address - Country:US
Mailing Address - Phone:770-820-3181
Mailing Address - Fax:678-964-2202
Practice Address - Street 1:2385 WALL ST SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2187
Practice Address - Country:US
Practice Address - Phone:770-820-3181
Practice Address - Fax:678-964-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001422251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health