Provider Demographics
NPI:1346748670
Name:COMPREHENSIVE TOTAL CARE, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE TOTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-315-5165
Mailing Address - Street 1:3169 ABBEY DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5477
Mailing Address - Country:US
Mailing Address - Phone:252-315-5165
Mailing Address - Fax:
Practice Address - Street 1:220 AVALON CIR STE B
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-7670
Practice Address - Country:US
Practice Address - Phone:252-315-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health