Provider Demographics
NPI:1417442856
Name:COMPREHENSIVE LIFE SOLUTIONS
Entity Type:Organization
Organization Name:COMPREHENSIVE LIFE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCENO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-410-2566
Mailing Address - Street 1:PO BOX 2904
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23327-2904
Mailing Address - Country:US
Mailing Address - Phone:757-410-2566
Mailing Address - Fax:
Practice Address - Street 1:138 S ROSEMONT RD STE 209
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4366
Practice Address - Country:US
Practice Address - Phone:757-410-2566
Practice Address - Fax:888-374-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040088431041C0700X
261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326205840Medicaid