Provider Demographics
NPI:1275886574
Name:COMPREHENSIVE HEALTHCARE
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTHCARE
Other - Org Name:CENTRAL WASHINGTON COMPREHENSIVE MENTAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-575-4084
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-0959
Mailing Address - Country:US
Mailing Address - Phone:509-575-4084
Mailing Address - Fax:
Practice Address - Street 1:2715 SAINT ANDREWS LOOP
Practice Address - Street 2:SUITE C
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301
Practice Address - Country:US
Practice Address - Phone:509-412-1051
Practice Address - Fax:509-412-1052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-24
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA015251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1986108Medicaid
WA000190400Medicare PIN