Provider Demographics
NPI:1417278870
Name:CENTER FOR COMPREHENSIVE SERVICES, INC
Entity Type:Organization
Organization Name:CENTER FOR COMPREHENSIVE SERVICES, INC
Other - Org Name:NEURORESTORATIVE MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING AND COLLECTIONS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LOREYONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:813-626-1444
Mailing Address - Street 1:10150 HIGHLAND MANOR DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9713
Mailing Address - Country:US
Mailing Address - Phone:813-626-1444
Mailing Address - Fax:813-621-0770
Practice Address - Street 1:12101 WHISTON CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1258
Practice Address - Country:US
Practice Address - Phone:813-626-1444
Practice Address - Fax:813-621-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities