Provider Demographics
NPI:1346552833
Name:COMPREHENSIVE HOLISTIC REHAB
Entity Type:Organization
Organization Name:COMPREHENSIVE HOLISTIC REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:OBTENU
Authorized Official - Last Name:BONENFANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-594-7769
Mailing Address - Street 1:3898 WEST COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-944-9040
Mailing Address - Fax:954-678-9174
Practice Address - Street 1:3898 WEST COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-944-9040
Practice Address - Fax:954-678-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty